Individual
IVA GAVASSI JORGE FERNANDES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
29 CONSTITUTION RD, LEXINGTON, MA 02421-6628
(617) 949-1574
Mailing address
29 CONSTITUTION RD, LEXINGTON, MA 02421-6628
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
MA
Other
Enumeration date
03/16/2026
Last updated
03/16/2026
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