Individual
DR. MARIA IDA SANNELLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
680 CENTRE ST, BROCKTON, MA 02302
(508) 583-2900
(508) 894-0412
Mailing address
680 CENTRE ST, BROCKTON, MA 02302
(508) 583-2900
(508) 894-0412
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
225318
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1200283
—
MA
Enumeration date
05/23/2006
Last updated
01/12/2024
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