Individual
JOHANN NIKOLAS PATLAK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
330 BROOKLINE AVE, BOSTON, MA 02215-5400
(617) 667-3112
Mailing address
330 BROOKLINE AVE, BOSTON, MA 02215-5400
(617) 667-3364
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
269792
MA
207L00000X
Anesthesiology Physician
Primary
MD16257
RI
207LC0200X
Critical Care Medicine (Anesthesiology) Physician
269792
MA
207LC0200X
Critical Care Medicine (Anesthesiology) Physician
MD16257
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
110121258A
—
MA
Enumeration date
03/20/2012
Last updated
02/20/2023
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