Individual
LYDIA B CAROLLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
197 ADAMS RD, WILLIAMSTOWN, MA 01267-2930
(413) 664-5900
(413) 664-5767
Mailing address
197 ADAMS RD, WILLIAMSTOWN, MA 01267-2930
(413) 458-8182
(413) 458-3140
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
24
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
9000419
—
VT
Enumeration date
12/30/2005
Last updated
10/07/2011
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