Individual
ELISA GAO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-BC
Contact information
Practice address
24 NEWTON ST, SOUTHBOROUGH, MA 01772-1215
(508) 460-3250
(508) 453-8152
Mailing address
5 NEPONSET ST, ATTN:MEDICAL STAFF SERVICES, WORCESTER, MA 01606-2714
(508) 852-0600
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
2362747
MA
363L00000X
Nurse Practitioner
Primary
RN2362747
MA
Other
Enumeration date
02/19/2025
Last updated
05/04/2026
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