Ellen M Gravallese, M.D.
Internal Medicine, Rheumatology in Worcester, MA. Individual provider (NPI-1).
NPI number1609866607
StatusActive
Last updated in NPPESDec 9, 2010
Details
- NPI
- 1609866607
- Entity type
- Individual (NPI-1)
- Name
- Ellen M Gravallese
- Credential
- M.D.
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Oct 21, 2005
- Last updated
- Dec 9, 2010
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207RR0500X | Internal Medicine, Rheumatology | 50113 | MA | Yes |
Practice location
55 Lake Ave NWorcester, MA 01655-0002
Phone 508-334-5224
Mailing address
Po Box 415348Boston, MA 02241-5348
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