| NPI | 1598578064 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DENISE BONAVITA Vice President Business Admin 781-337-0201 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208800000X Urology |
| Additional Taxonomies | 2085U0001X Radiology, Diagnostic Ultrasound |
| 363L00000X Nurse Practitioner | |
| Enumeration Date | 2025-01-29 |
| Last Update Date | 2025-01-29 |