Individual
KATHRYN E BONGIOVANNI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
2014 WASHINGTON ST, NEWTON, MA 02462-1607
(617) 243-6040
(617) 243-6924
Mailing address
6 LAKEVILLE BUSINESS PARK, LAKEVILLE, MA 02347-1234
(508) 946-6895
(508) 946-1494
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA4020
MA
Other
Enumeration date
09/02/2010
Last updated
09/02/2010
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