Provider Demographics
NPI:1245851021
Name:BAGLINI, CHRISTIAN (RN, MS)
Entity type:Individual
Prefix:MR
First Name:CHRISTIAN
Middle Name:
Last Name:BAGLINI
Suffix:
Gender:M
Credentials:RN, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24 RAWSON ST UNIT 3
Mailing Address - Street 2:
Mailing Address - City:DORCHESTER
Mailing Address - State:MA
Mailing Address - Zip Code:02125-1293
Mailing Address - Country:US
Mailing Address - Phone:203-815-3174
Mailing Address - Fax:
Practice Address - Street 1:11 NEVINS ST STE 501
Practice Address - Street 2:
Practice Address - City:BRIGHTON
Practice Address - State:MA
Practice Address - Zip Code:02135-3514
Practice Address - Country:US
Practice Address - Phone:617-789-6700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-05-03
Last Update Date:2021-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MAAG06200203363L00000X
MARN2335047163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163W00000XNursing Service ProvidersRegistered Nurse