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1366658502
GREGORY P DECONCILIIS
WALTHAM, MA
NPI
1366658502
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
363AS0400X Physician Assistant, Surgical
(Licence: MA 1250)
Enumeration Date
2007-05-15
Last Update Date
2007-07-08
Business Address
-- GREGORY P DECONCILIIS P.A.-C
840 WINTER ST. BOSTON OUT-PATIENT SURGICAL SUITES, LLC
WALTHAM, MA 02451
Phone number: 781-895-4908
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Mailing Address
-- GREGORY P DECONCILIIS P.A.-C
22 CHARLEMONT ST
NEWTON, MA 02461-1908
Phone number: 617-233-6804
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