Provider Demographics
NPI:1568433894
Name:LESAGE, LINDA (RN,MS,CS)
Entity Type:Individual
Prefix:MS
First Name:LINDA
Middle Name:
Last Name:LESAGE
Suffix:
Gender:F
Credentials:RN,MS,CS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:117 LINCOLN ST
Mailing Address - Street 2:
Mailing Address - City:HUDSON
Mailing Address - State:MA
Mailing Address - Zip Code:01749-1448
Mailing Address - Country:US
Mailing Address - Phone:978-562-3832
Mailing Address - Fax:617-527-0157
Practice Address - Street 1:255 WASHINGTON ST
Practice Address - Street 2:SUITE 402
Practice Address - City:NEWTON
Practice Address - State:MA
Practice Address - Zip Code:02458-1637
Practice Address - Country:US
Practice Address - Phone:617-527-0239
Practice Address - Fax:617-527-0157
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-01-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA138100163WP0809X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0809XNursing Service ProvidersRegistered NursePsychiatric/Mental Health, Adult
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA589929Medicare UPIN
MALE NS0304Medicare ID - Type Unspecified