Basic Information
| Provider Information | |||||||||
| NPI: | 1427543925 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SCHLESINGER | ||||||||
| FirstName: | ELIZABETH | ||||||||
| MiddleName: | BANCROFT | ||||||||
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| Mailing Information | |||||||||
| Address1: | 25 BRAINTREE HILL PARK STE 101 | ||||||||
| Address2: | |||||||||
| City: | BRAINTREE | ||||||||
| State: | MA | ||||||||
| PostalCode: | 021848715 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7819715019 | ||||||||
| FaxNumber: | 7818175821 | ||||||||
| Practice Location | |||||||||
| Address1: | 391 BROADWAY | ||||||||
| Address2: | |||||||||
| City: | EVERETT | ||||||||
| State: | MA | ||||||||
| PostalCode: | 021493470 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7819715019 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 06/27/2018 | ||||||||
| LastUpdateDate: | 04/16/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 04/16/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LG0600X | RN2282072 | MA | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Gerontology | 163W00000X | RN2282072 | MA | N | Nursing Service Providers | Registered Nurse |
No ID Information.