Provider Demographics
NPI:1427535913
Name:RUSU, PATRICIA ADELINE (RN)
Entity Type:Individual
Prefix:
First Name:PATRICIA
Middle Name:ADELINE
Last Name:RUSU
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:38 SUNNYSIDE RD
Mailing Address - Street 2:
Mailing Address - City:QUINCY
Mailing Address - State:MA
Mailing Address - Zip Code:02169-1234
Mailing Address - Country:US
Mailing Address - Phone:617-548-0366
Mailing Address - Fax:
Practice Address - Street 1:2 POND PARK RD STE 308
Practice Address - Street 2:
Practice Address - City:HINGHAM
Practice Address - State:MA
Practice Address - Zip Code:02043-4354
Practice Address - Country:US
Practice Address - Phone:781-740-7840
Practice Address - Fax:781-740-9840
Is Sole Proprietor?:No
Enumeration Date:2018-07-26
Last Update Date:2018-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN2313417163WS0121X, 163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
No163WS0121XNursing Service ProvidersRegistered NursePlastic Surgery