Individual
VASSILIKI A BOUSSIOTIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD PHD
Contact information
Practice address
100 BLOSSOM ST, HEMATOLOGY ONCOLOGY ASSOCIATES COX 2, BOSTON, MA 02114-2606
(617) 724-3200
Mailing address
PO BOX 9142, MASS GENERAL PHYSICIAN ORGANIZATION, CHARLESTOWN, MA 02129-9142
(617) 724-0287
(617) 726-2894
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
220011
MA
207RH0003X
Hematology & Oncology Physician
Primary
220011
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2096030
—
MA
01
—
470044
TUFTS HEALTH PLAN
MA
01
—
J28375
BCBS MA
MA
Enumeration date
11/18/2005
Last updated
06/24/2011
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