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Provider Information for 1982642559

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Please Note: Issuance of an NPI does not ensure or validate that the Health Care Provider is Licensed or Credentialed. For more information please refer to NPI: What You Need to Know

DR. ANDREA STRACCIOLINI MD

Gender: FEMALE

Individual NPI: 1982642559

Calendar   Last Updated:  2015-08-27
  Certification Date: 

Details

Name Value
NPI 1982642559
Enumeration Date 2006-06-03
NPI Type 1 - Individual
Sole Proprietor YES
Status Active
Mailing Address 319 LONGWOOD AVE
BOSTON, MA 02115-5728
United States

Phone: 617-355-6028 | Fax: 617-731-5298
View Map External Link
Primary Practice Address 319 LONGWOOD AVE
BOSTON, MA 02115-5728
United States

Phone: 617-355-6028 | Fax: 617-731-5298
View Map External Link
Health Information Exchange
Endpoint Type Endpoint Endpoint Description Use Content Type Affiliation Endpoint Location
Other Identifiers
Issuer State Number
MEDICAID MA 3193230
Taxonomy
Primary Taxonomy Selected Taxonomy State License Number
Yes 2080S0010X - Pediatrics Sports Medicine MA 153377
No 208000000X - Pediatrics MA 153377
No 2080P0204X - Pediatrics Pediatric Emergency Medicine MA 153377