Individual
ILANA AMBROGI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
564 MAIN ST, WALTHAM, MA 02452-5516
(781) 693-3800
Mailing address
495 WESTERN AVE, BRIGHTON, MA 02135-1007
(617) 783-0500
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
263783
MA
Other
Enumeration date
04/26/2012
Last updated
10/12/2015
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