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Individual

JACQUELINE PORTENY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
145 HARRISON AVE, BOSTON, MA 02111-1802
(512) 810-3122
Mailing address
800 WASHINGTON ST, BOSTON, MA 02111-1552
(617) 542-6165

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
3020454
MA
390200000X
Student in an Organized Health Care Education/Training Program
Primary

Other

Enumeration date
04/18/2025
Last updated
04/03/2026
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