Provider Demographics
NPI:1053811430
Name:MELANSON-ADAMS, LEIGH (ELECTROLOGIST)
Entity type:Individual
Prefix:
First Name:LEIGH
Middle Name:
Last Name:MELANSON-ADAMS
Suffix:
Gender:F
Credentials:ELECTROLOGIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:117 GROVER ST
Mailing Address - Street 2:
Mailing Address - City:BEVERLY
Mailing Address - State:MA
Mailing Address - Zip Code:01915-1542
Mailing Address - Country:US
Mailing Address - Phone:978-578-6332
Mailing Address - Fax:
Practice Address - Street 1:382 LOWELL ST
Practice Address - Street 2:
Practice Address - City:WAKEFIELD
Practice Address - State:MA
Practice Address - Zip Code:01880-1972
Practice Address - Country:US
Practice Address - Phone:781-245-0005
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-02-13
Last Update Date:2018-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1370207NS0135X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207NS0135XAllopathic & Osteopathic PhysiciansDermatologyProcedural Dermatology