Healthcare Provider Details

I. General information

NPI: 1649444894
Provider Name (Legal Business Name): LESLY AMARAL
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/18/2008
Last Update Date: 04/18/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

687 N MAIN ST
ATTLEBORO MA
02703-1518
US

IV. Provider business mailing address

687 N MAIN ST
ATTLEBORO MA
02703-1518
US

V. Phone/Fax

Practice location:
  • Phone: 508-222-3200
  • Fax: 508-222-7034
Mailing address:
  • Phone: 508-222-3200
  • Fax: 508-222-7034

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code246ZS0410X
TaxonomySurgical Technologist
License Number86781
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: