Provider Demographics
NPI:1255460770
Name:LENGIEZA, JUDITH ELAINE (MS RNC)
Entity type:Individual
Prefix:MRS
First Name:JUDITH
Middle Name:ELAINE
Last Name:LENGIEZA
Suffix:
Gender:F
Credentials:MS RNC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8 KAREN AVE
Mailing Address - Street 2:
Mailing Address - City:AUBURN
Mailing Address - State:MA
Mailing Address - Zip Code:01501-1209
Mailing Address - Country:US
Mailing Address - Phone:508-832-6191
Mailing Address - Fax:
Practice Address - Street 1:88 MASONIC HOME ROAD
Practice Address - Street 2:
Practice Address - City:CHARLTON
Practice Address - State:MA
Practice Address - Zip Code:01507
Practice Address - Country:US
Practice Address - Phone:508-434-3200
Practice Address - Fax:508-434-3218
Is Sole Proprietor?:No
Enumeration Date:2007-03-02
Last Update Date:2011-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA155088363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health