Individual
MS. LYNN WIWANTO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
23 WARREN AVE STE 100, WOBURN, MA 01801-4979
(781) 933-1198
Mailing address
1493 CAMBRIDGE STREET, CAMBRIDGE, MA 02139
(617) 665-1000
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
1013861
MA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/01/2020
Last updated
04/09/2024
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