SANDRA CUSTODIO AGPCNP-BC MSN RN NPI 1669886396

NPI Information

NPI: 1669886396
Provider Name: SANDRA CUSTODIO, AGPCNP-BC, MSN, RN
Classification: Nurse Practitioner - 363LA2200X
Entity Type: Individual

Specialization: Adult Health

PECOS Registration: Yes

Address:
874 PURCHASE ST
NEW BEDFORD, MA
ZIP 02740
Phone: (508) 992-6553
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Sandra Custodio, AGPCNP-BC, MSN, RN is an adult health nurse practitioner in New Bedford, MA with 4 years of experience. Sandra Custodio, AGPCNP-BC, MSN, RN NPI is 1669886396. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

874 PURCHASE ST
NEW BEDFORD, MA
ZIP 02740-232
Phone: (508) 992-6553

The NPI 1669886396 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 6/20/2014 and was last updated on 8/4/2020.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	163W00000X	Registered Nurse		RN2328892	MASSACHUSETTS	No
2	363LA2200X	Nurse Practitioner	Adult Health	RN2328892	MASSACHUSETTS	Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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