Individual
NANCY A BOLANIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
2014 WASHINGTON ST, NEWTON WELLESLEY RADIOLOGY ASSOCIATES, NEWTON, MA 02462
(617) 243-6600
Mailing address
PO BOX 417400, NEWTON WELLESLEY RADIOLOGY ASSOCIATES, BOSTON, MA 02241-0001
(800) 360-4391
(770) 776-5702
Taxonomy
Speciality
Code
Description
License number
State
2085B0100X
Body Imaging Physician
212726
MA
2085R0202X
Diagnostic Radiology Physician
Primary
212726
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0199648
—
MA
01
—
7707370
AETNA
—
01
—
J25265
BS
MA
Enumeration date
01/03/2006
Last updated
09/27/2011
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