Individual
DIANE GENGO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1493 CAMBRIDGE ST, CAMBRIDGE, MA 02139-1047
(781) 338-0696
Mailing address
1493 CAMBRIDGE ST, CAMBRIDGE, MA 02139-1047
(781) 338-0696
Taxonomy
Speciality
Code
Description
License number
State
364S00000X
Clinical Nurse Specialist
Primary
161690
MA
Other
Enumeration date
06/01/2020
Last updated
06/01/2020
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