Individual
MICHELLE BOUSHKA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
860 WASHINGTON ST, BOSTON, MA 02111-1521
(617) 636-5566
Mailing address
6 CHANNING PL, CAMBRIDGE, MA 02138-3307
(915) 217-9217
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
Other
Enumeration date
05/26/2021
Last updated
06/17/2021
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