Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LP0200X | Nurse Practitioner - Pediatrics | 195864 | MA |
NPI | 1013985159 |
---|---|
Provider Name | Lucy Z Garbus |
First Address | Springfield, MA 01199-1001 |
Second Address | Springfield, MA 01105-1442 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/03/2006 |
Last Update Date | 18/05/2016 |