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Mr. Gallus Lereh Fotabong
Gerontology Nurse Practitioner in Lynn, Massachusetts
NPI 1821755513

Gallus Lereh Fotabong is a Gerontology Nurse Practitioner based in Lynn, MA and is specialized in Gerontology. Gallus Lereh Fotabong practices in Lynn, MA. The NPI Number for Gallus Lereh Fotabong is 1821755513 and holds a License No. AG11210066 (Massachusetts).

The current practice location address for Gallus Lereh Fotabong is 41 Harvest St, Lynn, MA and can be reached out via phone at 781-244-8473. You can also correspond with Gallus Lereh Fotabong through the mailing address at 41 HARVEST ST, LYNN, MA - 01902-1122 (mailing address contact number: 781-244-8473).

Location: 41 Harvest St, Lynn, MA, 01902-1122
person
Provider Profile Details
NPI Number
1821755513
Provider Name
Gallus Lereh Fotabong
Credential
Provider Entity Type
Individual
Gender
Male
Address
41 Harvest St, Lynn, MA, 01902-1122
Phone Number
781-244-8473
Fax Number
Provider Enumeration Date
11/17/2021
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
41 Harvest St
City
State
Zip
01902-1122
Phone Number
781-244-8473
Fax Number
person
Provider Business Mailing Address Details
Address
41 Harvest St
City
State
Zip
01902-1122
Phone Number
781-244-8473
Fax Number
person
Provider's Taxonomy Details 1
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Nurse Practitioner
Speciality
Gerontology
Taxonomy
License No.
AG11210066 (Massachusetts)
Definition
Definition to come...
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