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Individual

J. ROBERT LARRIEUX

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
720 HARRISON AVE, SUITE 1105, BOSTON, MA 02118-2371
(617) 414-2000
(617) 414-5798
Mailing address
720 HARRISON AVE, DOB 503, BOSTON, MA 02118-2371

Taxonomy

Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
55735
MA
207VF0040X
Urogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) Physician
Primary
55735
MA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
110043988A
MA
Enumeration date
11/21/2005
Last updated
09/28/2017
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