Individual
MS. VANYDIA SIMON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
214 COMMERCIAL ST, MALDEN, MA 02148-6716
(781) 321-0645
Mailing address
214 COMMERCIAL ST, MALDEN, MA 02148-6716
(781) 321-0645
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
S66285825
MA
Other
Enumeration date
06/01/2012
Last updated
06/01/2012
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