Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207QA0505X | Family Doctor - Adult Medicine | 274827 | MA |
NPI | 1316358005 |
---|---|
Provider Name | Dr. Cinthia Raquel Coleman Canales |
First Address | Lynn, MA 01902-3068 |
Second Address | Lynn, MA 01902 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/05/2014 |
Last Update Date | 28/06/2018 |