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Individual

MS. ILSA Y GRUNDER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
NP

Contact information

Practice address
55 LAKE AVE N, DEPARTMENT OF HEMATOLOGY ONCOLOGY, WORCESTER, MA 01655-0002
(508) 856-3509
Mailing address
5 NEPONSET ST, WORCESTER, MA 01606-2714
(508) 556-5400
(508) 556-5401

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
196255
MA

Other

Enumeration date
02/07/2007
Last updated
06/11/2021
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