Individual
DEO KANANA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1 BATHOL ST, WAKEFIELD, MA 01880-3655
(781) 245-7600
Mailing address
252 KENNEDY DR APT 312, MALDEN, MA 02148-3321
(857) 266-1934
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
LN102382
MA
Other
Enumeration date
10/02/2024
Last updated
10/02/2024
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