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Organization

GAMBARU CORP

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DOLORES IVETTE KERSHAW OTR (PRESIDENT)
(781) 558-9565
Entity
Organization

Contact information

Practice address
999 BROADWAY, SUITE 100, SAUGUS, MA 01906-4521
(781) 558-9565
(781) 558-9567
Mailing address
999 BROADWAY, SUITE 100, SAUGUS, MA 01906-4521
(781) 558-9565
(781) 558-9567

Taxonomy

Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0324621
MA
Enumeration date
04/07/2011
Last updated
04/07/2011
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