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Nelly Padua
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NPI Number Detailed Information
Provider Information:
| Name: | Nelly Padua |
| Gender: | F |
| Provider License Number If Given: | 207263 |
NPI Information:
| NPI: | 1568457083 |
| Entity Type (Individual or Organization): |
1-ind |
| Enumeration Date: | 9/12/2005 |
| Last Update Date: | 8/15/2018 |
Provider Business Mailing Address:
| Address: | 700 ESSEX ST 700 ESSEX STREET Lawrence, MA 01841 |
| Phone Number: | 9786892400 |
| Fax Number: | 9786830663 |
Provider Business Practice Location Address:
| Address: | 700 ESSEX ST 700 ESSEX STREET Lawrence, MA 01841 |
| Phone Number: | 9786892400 |
| Fax Number: | 9787223037 |
Provider Taxonomy:
| Primary: | 363L00000X |
| Secondary (if any): | |
| State: | MA |
