Individual
HOWARD REVILLA HERNANDEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
14 PORTER ST, BOSTON, MA 02128-2116
(617) 912-7500
(617) 569-7890
Mailing address
14 PORTER ST, BOSTON, MA 02128-2116
(617) 912-7500
(617) 569-7890
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
250377
MA
2084P0804X
Child & Adolescent Psychiatry Physician
Primary
250377
MA
Other
Enumeration date
07/22/2008
Last updated
04/13/2015
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