Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086S0129X | Vascular Surgeon | 34589 | MA |
NPI | 1003937152 |
---|---|
Provider Name | Nicholas A Sannella |
First Address | Andover, MA 01810-2573 |
Second Address | Andover, MA 01810-2573 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/04/2007 |
Last Update Date | 08/07/2007 |