Individual
ELISE BOGNANNO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
269 UNION ST, LYNN, MA 01901-1314
(781) 581-3900
Mailing address
208 NORWEST DR, NORWOOD, MA 02062-1479
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
4301111442
MI
Other
Enumeration date
06/14/2013
Last updated
10/07/2020
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