Provider Demographics
NPI:1700673647
Name:MOSIO, MONIKA WIKTORIA
Entity type:Individual
Prefix:
First Name:MONIKA
Middle Name:WIKTORIA
Last Name:MOSIO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30 RIVER ST
Mailing Address - Street 2:
Mailing Address - City:DUDLEY
Mailing Address - State:MA
Mailing Address - Zip Code:01571-6802
Mailing Address - Country:US
Mailing Address - Phone:774-262-5336
Mailing Address - Fax:
Practice Address - Street 1:30 RIVER ST
Practice Address - Street 2:
Practice Address - City:DUDLEY
Practice Address - State:MA
Practice Address - Zip Code:01571-6802
Practice Address - Country:US
Practice Address - Phone:774-262-5336
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-23
Last Update Date:2025-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant