Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LN0005X | Nurse Practitioner - Neonatal (Critical Care) | 104427265 | MA |
NPI | 1003584277 |
---|---|
Provider Name | Lauren Grant Zwick |
First Address | Melrose, MA 02176-6143 |
Second Address | Boston, MA 02215-5491 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/09/2021 |
Last Update Date | 02/09/2021 |