Individual
MARK JOSEPH DELEO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
1 BOSTON MEDICAL CTR PL, BCD 1ST FL, BOSTON, MA 02118-2908
(617) 414-5481
(617) 414-7759
Mailing address
960 MASSACHUSETTS AVENUE, FL 2, BOSTON, MA 02118-2690
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA8375
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
110176275A
—
MA
05
—
3138404
—
NH
Enumeration date
06/29/2016
Last updated
06/02/2023
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