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Individual

GALLAUDET HOWARD

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CNP

Contact information

Practice address
269 UNION ST, LYNN, MA 01901-1314
(781) 581-3900
(781) 598-1050
Mailing address
P.O. BOX 526, LYNN, MA 01903
(781) 596-2502
(781) 596-3966

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
107095
IA
363LF0000X
Family Nurse Practitioner
Primary
RN206843
MA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0474569
IA
Enumeration date
03/28/2006
Last updated
05/25/2017
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