Healthcare Provider Details

I. General information

NPI: 1568433894
Provider Name (Legal Business Name): LINDA LESAGE R.N.,M.S.,C.S
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 01/26/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

255 WASHINGTON ST SUITE 402
NEWTON MA
02458-1637
US

IV. Provider business mailing address

117 LINCOLN ST
HUDSON MA
01749-1448
US

V. Phone/Fax

Practice location:
  • Phone: 617-527-0239
  • Fax: 617-527-0157
Mailing address:
  • Phone: 978-562-3832
  • Fax: 617-527-0157

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP0809X
TaxonomyAdult Psychiatric/Mental Health Registered Nurse
License Number138100
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: