Individual
DR. AUDREY M PROVENZANO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
801 MASSACHUSETTS AVE, STE 5B, CROSSTOWN BLDG, BOSTON, MA 02118
(617) 414-5951
(617) 414-9201
Mailing address
960 MASSACHUSETTS AVE STE 2, BOSTON, MA 02118-2690
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
253623
MA
Other
Enumeration date
06/02/2010
Last updated
10/06/2023
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