Individual
KELLY A BOTSOGLOU
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
2014 WASHINGTON ST, NEWTON, MA 02462-1607
(617) 243-6000
Mailing address
PO BOX 415348, BOSTON, MA 02241-5348
(800) 225-8885
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA7298
MA
Other
Enumeration date
01/29/2016
Last updated
08/27/2024
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