Individual
RICHARD ANTONELLI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
300 LONGWOOD AVE, CHILDREN'S HOSPITAL BOSTON PRIMARY CARE CENTER, BOSTON, MA 02115-5724
(617) 355-7701
(617) 730-0505
Mailing address
300 LONGWOOD AVE, CHILDREN'S HOSPITAL BOSTON PRIMARY CARE CENTER, BOSTON, MA 02115-5724
(617) 355-7701
(617) 730-0505
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
043502
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001435024
—
CT
Enumeration date
02/07/2006
Last updated
02/11/2009
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