Provider Demographics
NPI:1720971716
Name:JOSIL, ROBERTA
Entity type:Individual
Prefix:
First Name:ROBERTA
Middle Name:
Last Name:JOSIL
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 1:61 N GLENWAY AVE
Mailing Address - Street 2:
Mailing Address - City:RANDOLPH
Mailing Address - State:MA
Mailing Address - Zip Code:02368-5450
Mailing Address - Country:US
Mailing Address - Phone:857-312-2301
Mailing Address - Fax:
Practice Address - Street 1:61 N GLENWAY AVE
Practice Address - Street 2:
Practice Address - City:RANDOLPH
Practice Address - State:MA
Practice Address - Zip Code:02368-5450
Practice Address - Country:US
Practice Address - Phone:857-312-2301
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-30
Last Update Date:2025-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN2342894163WG0100X, 163WI0500X, 163WI0600X, 163WX1500X, 163WM0705X, 163WP0809X, 163WW0000X, 163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
No163WG0100XNursing Service ProvidersRegistered NurseGastroenterology
No163WI0500XNursing Service ProvidersRegistered NurseInfusion Therapy
No163WI0600XNursing Service ProvidersRegistered NurseInfection Control
No163WX1500XNursing Service ProvidersRegistered NurseOstomy Care
No163WM0705XNursing Service ProvidersRegistered NurseMedical-Surgical
No163WP0809XNursing Service ProvidersRegistered NursePsychiatric/Mental Health, Adult
No163WW0000XNursing Service ProvidersRegistered NurseWound Care