Individual
LISA M ANTONELLI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
266 RINDGE AVE # B, CAMBRIDGE, MA 02140-3202
(617) 665-3340
Mailing address
266 RINDGE AVE # B, CAMBRIDGE, MA 02140-3202
(617) 665-3340
Taxonomy
Speciality
Code
Description
License number
State
363LP2300X
Primary Care Nurse Practitioner
Primary
87024
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
NP1476
BCBS MA
MA
Enumeration date
11/21/2006
Last updated
11/15/2007
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