Individual
FRED NTALO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
89 FAIRMOUNT AVE, SAUGUS, MA 01906-1424
(857) 233-7392
Mailing address
89 FAIRMOUNT AVE, SAUGUS, MA 01906-1424
(857) 233-7392
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
LN87257
MA
Other
Enumeration date
03/19/2020
Last updated
03/19/2020
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