Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 152W00000X | Optometrist | 5186 | MA |
NPI | 1003367145 |
---|---|
Provider Name | Dr. Melda Nil Gerow |
First Address | Salem, MA 01970 |
Second Address | Salem, MA 01970 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/10/2016 |
Last Update Date | 13/02/2021 |