Provider Demographics
NPI:1871147363
Name:LOCOCO, DANIEL VINCENT (NP-C)
Entity type:Individual
Prefix:MR
First Name:DANIEL
Middle Name:VINCENT
Last Name:LOCOCO
Suffix:
Gender:M
Credentials:NP-C
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Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:830 BOYLSTON ST STE 106
Mailing Address - Street 2:
Mailing Address - City:CHESTNUT HILL
Mailing Address - State:MA
Mailing Address - Zip Code:02467-2502
Mailing Address - Country:US
Mailing Address - Phone:617-277-1205
Mailing Address - Fax:617-232-6528
Practice Address - Street 1:830 BOYLSTON ST STE 106
Practice Address - Street 2:
Practice Address - City:CHESTNUT HILL
Practice Address - State:MA
Practice Address - Zip Code:02467-2599
Practice Address - Country:US
Practice Address - Phone:617-277-1205
Practice Address - Fax:617-232-6528
Is Sole Proprietor?:No
Enumeration Date:2019-08-01
Last Update Date:2023-12-28
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MARN2304622363L00000X
NH081123-23363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner