Provider Demographics
NPI:1376615096
Name:GIORGI, MARISA A (NP)
Entity Type:Individual
Prefix:MRS
First Name:MARISA
Middle Name:A
Last Name:GIORGI
Suffix:
Gender:F
Credentials:NP
Other - Prefix:MS
Other - First Name:MARISA
Other - Middle Name:ALESSANDRA
Other - Last Name:GIORGI
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:FNP
Mailing Address - Street 1:124 GROVE ST
Mailing Address - Street 2:SUITE 305
Mailing Address - City:FRANKLIN
Mailing Address - State:MA
Mailing Address - Zip Code:02038-3156
Mailing Address - Country:US
Mailing Address - Phone:508-528-5392
Mailing Address - Fax:508-541-2420
Practice Address - Street 1:18 GRANITE STREET
Practice Address - Street 2:BLACKSTONE VALLEY FAMILY PRACTICE
Practice Address - City:WHITINSVILLE
Practice Address - State:MA
Practice Address - Zip Code:01588-1908
Practice Address - Country:US
Practice Address - Phone:508-234-6311
Practice Address - Fax:508-234-4215
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-15
Last Update Date:2010-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA229093363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA98198OtherFALLON HEALTH PLAN
MANP2208OtherBLUE CROSS BLUE SHIELD
MANP2208Medicare PIN
MA98198OtherFALLON HEALTH PLAN
MANP2208OtherBLUE CROSS BLUE SHIELD