Provider Demographics
NPI:1053346114
Name:PENSO, ELLEN M (MD)
Entity type:Individual
Prefix:
First Name:ELLEN
Middle Name:M
Last Name:PENSO
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Gender:F
Credentials:MD
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Mailing Address - Street 1:241 BOSTON POST RD
Mailing Address - Street 2:SUITE 3A
Mailing Address - City:WAYLAND
Mailing Address - State:MA
Mailing Address - Zip Code:01778-1836
Mailing Address - Country:US
Mailing Address - Phone:508-358-5707
Mailing Address - Fax:508-358-5709
Practice Address - Street 1:241 BOSTON POST RD
Practice Address - Street 2:SUITE 3A
Practice Address - City:WAYLAND
Practice Address - State:MA
Practice Address - Zip Code:01778-1836
Practice Address - Country:US
Practice Address - Phone:508-358-5707
Practice Address - Fax:508-358-5709
Is Sole Proprietor?:No
Enumeration Date:2006-07-11
Last Update Date:2010-11-09
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Provider Licenses
StateLicense IDTaxonomies
MA47131207VG0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecology