Individual
MR. SAMIR GANDULLA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
12 METHUEN ST, 1ST FLOOR, LAWRENCE, MA 01840-1700
(978) 794-7966
Mailing address
25 MOUNT VERNON ST, APT. 25, HAVERHILL, MA 01830-6047
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
01/11/2013
Last updated
01/11/2013
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