Provider Demographics
NPI:1447949987
Name:RANJO, PETER MICHAEL
Entity type:Individual
Prefix:
First Name:PETER
Middle Name:MICHAEL
Last Name:RANJO
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:26 BRISTOL RD
Mailing Address - Street 2:
Mailing Address - City:PEMBROKE
Mailing Address - State:MA
Mailing Address - Zip Code:02359-2139
Mailing Address - Country:US
Mailing Address - Phone:774-454-5599
Mailing Address - Fax:
Practice Address - Street 1:26 BRISTOL RD
Practice Address - Street 2:
Practice Address - City:PEMBROKE
Practice Address - State:MA
Practice Address - Zip Code:02359-2139
Practice Address - Country:US
Practice Address - Phone:774-454-5599
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-02
Last Update Date:2023-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN2361548163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse