Individual
LYDIA N GONSALVES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
879 LEXINGTON ST # 7A, WALTHAM, MA 02452-4851
(682) 347-0587
Mailing address
879 LEXINGTON ST # 7A, WALTHAM, MA 02452-4851
(682) 347-0587
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
LN102411
MA
Other
Enumeration date
10/15/2024
Last updated
10/15/2024
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