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General NPI Number Information
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NPI Number | 1275718934
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Entity Type | Organization
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Legal Business Name | LUCETTE NADLE DO
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Dates
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Enumeration Date | 12/31/2007
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Last Update Date | 12/31/2007
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Provider Practice Location Address
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Address Line | 160 E MAIN ST STE 1E
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City | WESTBOROUGH
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State | MA
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Zip | 01581-1758
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Country | US
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Telephone | 508-366-9686
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Fax | 508-366-9435
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Provider Business Mailing Address
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Address Line | 160 E MAIN ST STE 1E
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City | WESTBOROUGH
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State | MA
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Zip | 01581-1758
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Country | US
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Telephone | 508-366-9686
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Fax | 508-366-9435
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Authorized Official
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Title or Position | OWNER
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Name | DR. LUCETTE NADLE
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Credential | DO
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Telephone | 508-366-9686
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 204D00000X
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Taxonomy Name | Neuromusculoskeletal Medicine & OMM Physician
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License Number | 55679
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License Number State | MA
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