Individual
BRIAN R PENTI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
850 HARRISON AVE, YACC 4, BOSTON, MA 02118-4001
(617) 414-2080
(617) 414-2090
Mailing address
720 HARRISON AVE, DOB 503, BOSTON, MA 02118-2371
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
229800
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
110075933A
—
MA
Enumeration date
08/20/2006
Last updated
07/10/2014
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