Most Relevant Information
Provider Data
| NPI Number: | 1003215872 |
| Provider Name: | DIANA RANDOLPH-MERCHANT |
| Entity Type: | Individual |
| Taxonomy Code: | 390200000X |
| Specialty: | Student in an Organized Health Care Education/Training Program |
| License Number: |
Most Important Dates
| Enumeration Date: | 08/18/2014 |
| Last Updated: | 08/18/2014 |
Provider Practice Location
95 PLEASANT ST
LYNN
MA
019011524
Practice Location Phone/Fax
| Phone: | 7812674444 |
| Fax: |
Provider Mailing Location
126 HIGHLAND AVE
SALEM
MA
019702724
Provider Mailing Phone/Fax
| Phone: | 9783288634 |
| Fax: |