Individual
MRS. ELISE ANNA BUCKLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
300 LONGWOOD AVE, BOSTON, MA 02115
(617) 355-6021
(617) 730-0092
Mailing address
300 LONGWOOD AVE, BOSTON, MA 02115
(617) 355-6021
(617) 730-0092
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
235121
MA
363LP0200X
Pediatric Nurse Practitioner
002924
CT
Other
Enumeration date
06/14/2006
Last updated
09/09/2011
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