Individual
KELLY GONCALVES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1210 PROVIDENCE HWY, NORWOOD, MA 02062-5061
(781) 255-0500
Mailing address
26 CENTRAL ST, SOMERVILLE, MA 02143-2827
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA6054
MA
Other
Enumeration date
03/01/2017
Last updated
09/17/2019
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