Individual
ILONA M KOPITS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D., M.P.H.
Contact information
Practice address
850 HARRISON AVENUE, YACC, 3RD FLOOR, BOSTON, MA 02118-4001
(617) 638-6100
(617) 638-6179
Mailing address
720 HARRISON AVENUE, DOB 503, BOSTON, MA 02118
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
230334
MA
207QG0300X
Geriatric Medicine (Family Medicine) Physician
Primary
230334
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
110075317A
—
MA
Enumeration date
11/06/2006
Last updated
08/14/2014
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