Individual
MS. GANAM KONIKARA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CPNP-PC
Contact information
Practice address
288 LYMAN ST, WESTBOROUGH, MA 01581-2664
(508) 792-7611
Mailing address
288 LYMAN ST, WESTBOROUGH, MA 01581-2664
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
RN2268058
MA
Other
Enumeration date
09/22/2021
Last updated
10/14/2021
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