Search › Massachusetts › 207P00000X
Lydia Wallace
NPI 1417344581 · on the registry since 2015 · sole proprietor
Practice
- Address
- 235 N Pearl St
Brockton, MA 02301 - Phone
- (617) 414-5405
- Organisation at this address
- Mass Oncology, P.C.
Pathology Specialists Pc
Caritas Medical Group Inc
Steward Pet Imaging, L.L.C.
Luz Evangeline S Dizon Md PcInferred from a shared address, not stated in the registry. - Clinicians at this address
- 210
Additional practice sites
- 145 Harrison Ave, Boston, MA
- 101 Hospital Loop Ne, Albuquerque, NM
Registry record
- Primary taxonomy
- 207P00000X
207P00000X
- Also registered as
- 207P00000X
- Licence states on file
- NM, MA
From the registry's licence fields, which are often incomplete.
- Sex
- Female
- Record last updated
- 2025-08-02
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Massachusetts