Individual
ELSA S LI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
320 BOLTON ST, MARLBOROUGH, MA 01752-3988
(508) 460-9670
Mailing address
44 LONGFELLOW RD, NORTHBOROUGH, MA 01532-2724
(508) 393-7807
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
55407
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
110072575A
—
MA
Enumeration date
06/06/2006
Last updated
04/03/2012
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