| NPI | 1518548627 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JACLYN VALANZOLA Provider Enrollment 781-681-0384 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology |
| Additional Taxonomies | 207LC0200X Anesthesiology, Critical Care Medicine |
| 207LH0002X Anesthesiology, Hospice and Palliative Medicine | |
| 207LP2900X Anesthesiology, Pain Medicine | |
| Enumeration Date | 2021-04-20 |
| Last Update Date | 2024-01-23 |