Individual
KOUTA ITO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D., M.S.
Contact information
Practice address
291 LINCOLN ST, WORCESTER, MA 01605-3643
(508) 334-6251
(508) 334-6906
Mailing address
PO BOX 415348, BOSTON, MA 02241-5348
(800) 225-8885
(508) 334-1977
Taxonomy
Speciality
Code
Description
License number
State
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
Primary
266750
MA
Other
Enumeration date
03/06/2008
Last updated
05/01/2022
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