Individual
LARA KOVELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
55 LAKE AVE N, WORCESTER, MA 01655-0002
(508) 334-3452
Mailing address
P O BOX 415348, BOSTON, MA 02241-5348
(800) 225-8885
(508) 334-8105
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
270937
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
110124348A
—
MA
Enumeration date
04/11/2010
Last updated
11/10/2020
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