Individual
JENNIFER NICOLE DEPATIE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
55 FRUIT ST, WHITE 1, BOSTON, MA 02114-2696
(617) 724-4100
(617) 726-7415
Mailing address
9 JACKSON ST, HOPKINTON, MA 01748-2568
(774) 278-8272
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA101071
MA
Other
Enumeration date
07/24/2023
Last updated
09/25/2024
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