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Individual

ANTHONY VANNIEL

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
875 MASSACHUSETTS AVE, SUITE 51, CAMBRIDGE, MA 02139-3067
(617) 864-8482
Mailing address
875 MASSACHUSETTS AVE, SUITE 51, CAMBRIDGE, MA 02139-3067
(617) 864-8482

Taxonomy

Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
47553
MA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
J02423
BLUE CROSS
MA
Enumeration date
02/22/2006
Last updated
09/02/2011
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