Individual
MRS. ELAINE SM FERNANDES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
61 MEDFORD ST, SOMERVILLE, MA 02143-3421
(617) 629-3919
Mailing address
621 ARBORETUM WAY, BURLINGTON, MA 01803-3832
(978) 578-0860
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Enumeration date
09/14/2010
Last updated
09/14/2010
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