Organization Name: | LUCETTE NADLE DO |
NPI Number: | 1275718934 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | LUCETTE NADLE (OWNER) |
Mailing Address: | 160 E Main St Ste 1e Westborough |
State: | MA US |
Postal Code: | 015811758 |
Phone Number: | 5083669686 |
Fax Number: | 5083669435 |
NPI Enumeration Date: | 12/31/2007 |
NPI Last Update Date: | 12/31/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 204D00000X |
License Number: | 55679 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MA |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | Neuromusculoskeletal Medicine & OMM |
Taxonomy Specialization: | |
Taxonomy Definition: |