Individual
YANA ANTONELLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
N.P.
Contact information
Practice address
545A CENTRE ST, JAMAICA PLAIN, MA 02130-2061
(617) 522-5464
(617) 524-2966
Mailing address
545A CENTRE ST, JAMAICA PLAIN, MA 02130-2061
(617) 522-5464
(617) 524-2966
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
233109
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0322580
—
MA
Enumeration date
10/18/2005
Last updated
05/14/2008
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