NPI 1649941709 · live from the CMS NPI Registry
Alonso Bolivar, PA-C
Physician Assistant in Dedham, MA. National Provider Identifier 1649941709, active.
NPI record
| NPI | 1649941709 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Physician Assistant 363A00000X |
| Practice location | 983 Boston-Providence Turnpike, Dedham, MA 02026 |
| Practice phone | 781-819-6400 |
| Mailing address | 360 Us Highway 1 Byp Unit 102, Portsmouth, NH 03801 |
| Enumerated | September 27, 2021 |
| Last updated | November 14, 2023 |
| Sole proprietor | No |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Physician Assistant primary | 363A00000X | PA9018 (MA) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.