Individual
MARIA A PONSILLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
200 WEST ST, WALTHAM, MA 02451-1121
(781) 434-4226
Mailing address
68 ALBERTA RD, CHESTNUT HILL, MA 02467-3171
(781) 434-4226
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
75113
MA
Other
Enumeration date
08/20/2006
Last updated
07/08/2007
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