Provider Demographics
NPI:1689877847
Name:DICENZO, ALICE MARGARET (RN)
Entity Type:Individual
Prefix:
First Name:ALICE
Middle Name:MARGARET
Last Name:DICENZO
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 1:5 BRADFORD RD
Mailing Address - Street 2:
Mailing Address - City:WOBURN
Mailing Address - State:MA
Mailing Address - Zip Code:01801-5247
Mailing Address - Country:US
Mailing Address - Phone:781-933-0796
Mailing Address - Fax:
Practice Address - Street 1:5 BRADFORD RD
Practice Address - Street 2:
Practice Address - City:WOBURN
Practice Address - State:MA
Practice Address - Zip Code:01801-5247
Practice Address - Country:US
Practice Address - Phone:781-933-0796
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA123924163WD0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WD0400XNursing Service ProvidersRegistered NurseDiabetes Educator