MR. JUSTIN EUSEBIO (NPI# 1073166112) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1073166112 |
| Entity Type | Individual |
| Full Name | MR. JUSTIN EUSEBIO |
| Credential | MSN, RN, PMHNP-BC |
| Practice Address |
19 Tacoma St Worcester MA 01605-3516 |
| Practice Telephone | 5085951115 |
| Mailing Telephone | 5088521805 |
| Enumeration Date | 2019-07-18 |
| Last Update Date | 2020-01-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 163WP0808X |
Registered Nurse Specialization: Psych/Mental Health |
RN2320812 | MA | Nursing Service Providers |
| Y | 363LP0808X |
Nurse Practitioner Specialization: Psych/Mental Health |
RN2320812 | MA | Physician Assistants & Advanced Practice Nursing Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 300 Friberg Pkwy, Westborough, MA 015813900 | 5083296300 |
| Street Address |
19 TACOMA ST |
| City | WORCESTER |
| State | MA |
| Zip Code | 01605-3516 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114902038 | Gina E. D'ottavio | Family Medicine | 19 Tacoma St, Worcester, MA 01605-3516 | 2005-12-14 |
| 1952909319 | Michelle Elicier | Licensed Practical Nurse | 19 Tacoma St, Worcester, MA 01605-3516 | 2020-10-16 |
| 1396342275 | Christine Anne Tuohy | Registered Nurse | 19 Tacoma St, Worcester, MA 01605-3516 | 2020-10-05 |
| 1437756335 | Madeline Fennon Lane | Registered Nurse | 19 Tacoma St, Worcester, MA 01605-3516 | 2020-10-04 |
| 1962016584 | Julie Fraher | Registered Nurse | 19 Tacoma St, Worcester, MA 01605-3516 | 2020-09-01 |
| 1598377699 | Victor O Boadu | Registered Nurse | 19 Tacoma St, Worcester, MA 01605-3516 | 2020-08-19 |
| 1053922963 | Shanoska Vasquez Garcia | Counselor | 19 Tacoma St, Worcester, MA 01605-3516 | 2020-08-13 |
| 1588289300 | Jeffrey P Chhim | Registered Nurse | 19 Tacoma St, Worcester, MA 01605-3516 | 2020-06-09 |
| 1629692470 | Diana Portillo | Registered Nurse | 19 Tacoma St, Worcester, MA 01605-3516 | 2020-06-07 |
| 1467076810 | Stacie Robbins | Pharmacist | 19 Tacoma St, Worcester, MA 01605-3516 | 2020-06-02 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083228340 | Francisca A Bediako | Registered Nurse | Commonwealth Care Alliance, 100 North Parkway-suite # 202, Worcester, MA 01605 | 2020-09-03 |
| 1922660646 | Jenna Patricia Mullarkey | Counselor | Ummmc, Hahnemann Family Health Center, 279 Lincoln Street, Worcester, MA 01605 | 2019-07-02 |
| 1295219293 | Valerie Ann Wedge | Social Worker | 382 Plantation Street, Worcester, MA 01605 | 2018-09-17 |
| 1154800290 | Keri Innis-grant | Counselor | 108 Grove Street, Ste Ll11, Worcester, MA 01605 | 2018-08-09 |
| 1184119463 | Madiinah Namutebi | Registered Nurse | 56 Olga Ave, Worcester, MA 01605 | 2018-06-28 |
| 1841789310 | Ashley Murray | Psychologist | 361 Plantation St., Attn: Forensic Services, Worcester, MA 01605 | 2018-05-09 |
| 1184126419 | Nadia Saforo | Nurse Practitioner | 509 Plantation St Apt 221, Worcester, MA 01605 | 2018-03-02 |
| 1548779044 | Arnold Kamau Thuku | Behavioral Analyst | 55 Erie Ave, Worcester, MA 01605 | 2017-09-27 |
| 1417466483 | Sabine Erica Charles-arbouet | Registered Nurse | 25 Oriol Drive, Worcester, MA 01605 | 2017-09-21 |
| 1548787864 | Alyssa Lynn Champagne | Behavioral Analyst | 19 Judson Rd, Worcester, MA 01605 | 2017-08-28 |
| Find all providers in zip 01605 | ||||
| Taxonomy Code | 363LP0808X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Psych/Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144829177 | Amiee N Caruso | Nurse Practitioner | 26 Queen St Ste 4, Worcester, MA 01610-2473 | 2020-10-21 |
| 1871110221 | Jillian Bradley | Nurse Practitioner | 507 Plantation St Apt 519, Worcester, MA 01605-4326 | 2020-07-01 |
| 1407393010 | John Job | Nurse Practitioner | 130 Lincoln St Ste 6, Worcester, MA 01605-2430 | 2017-01-21 |
| 1457701807 | Jee Yeah Park | Nurse Practitioner | 162 Chandler Street, Worcester, MA 01609-2924 | 2016-06-16 |
| 1174137434 | Grace Njeri Ngumi | Nurse Practitioner | 30 Park Ave, Worcester, MA 01605-3945 | 2020-09-03 |
| 1518578426 | Aldona Angele Vainius | Nurse Practitioner | 255 Park Ave Ste 804, Worcester, MA 01609-1984 | 2020-08-13 |
| 1518505973 | Jessica Lynn Weissman | Nurse Practitioner | 55 Lake Ave N, Worcester, MA 01655-0002 | 2019-12-17 |
| 1063970234 | Edith N/a Claros | Nurse Practitioner | 19 Tacoma St, Worcester, MA 01605-3516 | 2019-03-06 |
| 1639633530 | Yui Kitayama | Nurse Practitioner | 72 Jaques Ave, Worcester, MA 01610-2476 | 2019-01-24 |
| 1710469549 | Kevin Phillipp Nardone | Nurse Practitioner | 435 Shrewsbury St, Worcester, MA 01604-1689 | 2018-08-29 |
| Find all providers in WORCESTER | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.