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Individual

LISA WESTCOTT VERCOLLONE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
1153 CENTRE ST, BOSTON, MA 02130-3446
(617) 983-7000
Mailing address
75 FRANCIS ST, BOSTON, MA 02115-6110

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
269351
MA
207R00000X
Internal Medicine Physician
MD60347934
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1386965028
WA
01
314292
LNI
WA
Enumeration date
06/17/2010
Last updated
12/05/2017
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