Individual
ELEANORE FAENZA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
55 LAKE AVE N, WORCESTER, MA 01655-0002
(508) 334-3452
(774) 442-6959
Mailing address
PO BOX 415348, BOSTON, MA 02241-5348
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
RN2279336
MA
363LA2100X
Acute Care Nurse Practitioner
Primary
RN2279336
MA
Other
Enumeration date
07/11/2018
Last updated
03/08/2022
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