Provider Demographics
NPI:1013325463
Name:BARON, LUILA F (NP)
Entity Type:Individual
Prefix:
First Name:LUILA
Middle Name:F
Last Name:BARON
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:LUILA
Other - Middle Name:F
Other - Last Name:LEAL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5 NEPONSET ST FL 12
Mailing Address - Street 2:
Mailing Address - City:WORCESTER
Mailing Address - State:MA
Mailing Address - Zip Code:01606-2714
Mailing Address - Country:US
Mailing Address - Phone:508-832-9621
Mailing Address - Fax:508-852-8570
Practice Address - Street 1:761 WORCESTER RD FL 4
Practice Address - Street 2:
Practice Address - City:FRAMINGHAM
Practice Address - State:MA
Practice Address - Zip Code:01701
Practice Address - Country:US
Practice Address - Phone:508-872-1260
Practice Address - Fax:508-879-7913
Is Sole Proprietor?:No
Enumeration Date:2014-07-30
Last Update Date:2022-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN277961363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA110133915AMedicaid