Healthcare Provider Details

I. General information

NPI: 1891609491
Provider Name (Legal Business Name): CORE & GLOW WELLNESS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/30/2026
Last Update Date: 09/30/2026
Certification Date: 09/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

40 BISCUIT HILL DR
LEOMINSTER MA
01453-3968
US

IV. Provider business mailing address

17 PIERCE AVE # 104
FITCHBURG MA
01420-7111
US

V. Phone/Fax

Practice location:
  • Phone: 978-490-8227
  • Fax:
Mailing address:
  • Phone: 351-209-6377
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number
License Number StateNULL

VIII. Authorized Official

Name: CYNTHIA GERONIMO
Title or Position: NURSE PRACTITIONER
Credential:
Phone: 351-209-6377