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Individual

JONATHAN Y BUCKWOLD

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
70 EAST ST, METHUEN, MA 01844-4597
(978) 687-0151
(617) 277-1403
Mailing address
77 WARREN ST, BRIGHTON, MA 02135-3601
(617) 562-5359
(617) 562-5415

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
71982
MA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
3120431
MA
Enumeration date
06/05/2006
Last updated
08/17/2015
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