Individual
MADELINE VAITAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
72 E CONCORD ST, BOSTON, MA 02118-2642
(617) 358-9518
Mailing address
350 W 4TH ST APT 304, BOSTON, MA 02127-2674
(248) 828-5943
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
MA
Other
Enumeration date
09/06/2024
Last updated
09/06/2024
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