Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VX0000X | Obstetrician | 50825 | MA |
NPI | 1295967669 |
---|---|
Provider Name | Dr. Robert Edward Dalessandro |
First Address | Leominster, MA 01453-4631 |
Second Address | Leominster, MA 01453-4631 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 18/08/2009 |
Last Update Date | 18/08/2009 |