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Individual

EZEQUIEL DE LEON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
NP

Contact information

Practice address
117 WATER ST, MILFORD, MA 01757-3036
(508) 478-4500
(508) 478-5235
Mailing address
455A LAKE AVE, WORCESTER, MA 01604-1366
(774) 287-0033

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
RN2337287
MA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
110091343A
MA
Enumeration date
05/11/2022
Last updated
04/08/2026
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