Individual
MARI J BENTLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
850 HARRISON AVENUE, YACC 5, BOSTON, MA 02118
(617) 414-2000
(617) 414-5798
Mailing address
801 ALBANY STREET, FL G, BOSTON, MA 02119-3791
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
0101261551
VA
207Q00000X
Family Medicine Physician
Primary
209027
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
110004861A
—
MA
Enumeration date
01/10/2006
Last updated
09/13/2023
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