Individual
VICTORIA H GANTZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
550 CABOT ST, BEVERLY, MA 01915-2511
(978) 927-1919
(978) 927-6102
Mailing address
LAHEY CLINIC, 41 MALL ROAD, BURLINGTON, MA 01805-0001
(781) 744-5100
(781) 744-5215
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
161983
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0383520
—
MA
Enumeration date
10/04/2006
Last updated
12/20/2011
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