Individual
DORISANNE YLLENA WONSOR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
450 BROOKLINE AVE, BOSTON, MA 02215-5450
(516) 473-4989
Mailing address
17 SHANLEY ST APT 1, BRIGHTON, MA 02135-3137
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA7386
MA
Other
Enumeration date
06/30/2019
Last updated
12/22/2021
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