Individual
MR. KEVIN RUSSELL BONVICINI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
75 FRANCIS ST, BOSTON, MA 02115-6110
(617) 732-7628
Mailing address
75 FRANCIS ST, BOSTON, MA 02115-6110
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
Other
Enumeration date
07/11/2021
Last updated
03/13/2022
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