Individual
MANISHA DUCASSE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
243 PARK ST, MEDFORD, MA 02155-2667
(781) 354-6889
Mailing address
243 PARK ST, MEDFORD, MA 02155-2667
(781) 354-6889
Taxonomy
Speciality
Code
Description
License number
State
163WG0000X
General Practice Registered Nurse
Primary
RN2373418
MA
Other
Enumeration date
01/12/2024
Last updated
01/12/2024
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