Individual
JENNIFER SHANNON PATOULIDIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
800 WASHINGTON ST, NEUROLOGY DEPT, BOSTON, MA 02111-1552
(617) 636-8488
Mailing address
35 KENMERE RD, MEDFORD, MA 02155-4117
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA4082
MA
Other
Enumeration date
11/17/2010
Last updated
08/25/2015
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