Individual
GRESILLA FONDI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
81 HIGHLAND AVE, SALEM, MA 01970-2714
(978) 335-2914
Mailing address
9 OSBORNE HILL DR, SALEM, MA 01970-1022
(978) 335-2914
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
RN268082
MA
390200000X
Student in an Organized Health Care Education/Training Program
648459
MA
Other
Enumeration date
10/09/2016
Last updated
05/09/2017
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