Theresa Gravallese Buks PA-C

NPI 1275828915 - Physician Assistant - 363A00000X

NPI Details
NPI 1275828915
Gender Female
Enumeration Date 06/10/2011
Last Updated 10/23/2014
Entity Type Individual
Active Over 6 years ago
Practice Location
1493 CAMBRIDGE ST
CAMBRIDGE MA, 02139-1047, US
Phone (617) 665-1309
Fax
Business Location
1493 CAMBRIDGE ST
CAMBRIDGE MA, 02139-1047, US
Phone (617) 665-1309
Fax
Toxanomy
Taxonomy Code 363A00000X
License State Massachusetts
License Number 4186
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According to our database, Mrs. Theresa Gravallese Buks PA-C NPI is 1275828915, taxonomy code is 363A00000X and license number is 4186, license state is located at Massachusetts. Theresa Gravallese Buks PA-C physically located at 1493 Cambridge St, Cambridge MA, 02139-1047. NPI Number Theresa Gravallese Buks PA-C has the Individual type.

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1275828915 NPI number is provided on an as is basis without warranty of any kind. 1275828915 is maintained by the National Plan & Provider Enumeration System. The contents of Theresa Gravallese Buks PA-C are for informational purposes only.