Individual
MIKAELA ELIA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
450 BROOKLINE AVE, BOSTON, MA 02215-5418
(617) 632-3000
Mailing address
450 BROOKLINE AVE, BOSTON, MA 02215-5418
(617) 632-3000
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA5552
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PA5552
MASSACHUSETTS HEALTH AND HUMAN SERVICES
MA
Enumeration date
10/20/2015
Last updated
10/20/2015
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