Deborah Antos, PA

Individual provider Active NPI Medical Physician Assistant · Braintree, MA

NPI 1295798437 · NPPES record last updated Jan 13, 2014

Key facts

NPI
1295798437
Entity type
Individual (NPI type 1)
Primary specialty
Medical Physician Assistant 363AM0700X
License
273 (MA)
Practice address
111 Grossman Dr
Braintree, MA 02184-4997
Phone
(781) 849-1000
NPI assigned
Apr 10, 2006
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
273MAMDHearing Instrument Specialist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 273 MA
Medical Physician Assistant 363AM0700X 273 MA Yes

Addresses

Primary practice location

111 Grossman Dr
Braintree, MA 02184-4997

Mailing address

147 Milk St
Provider Enrollment - 9TH Floor
Boston, MA 02109-4806
Phone (617) 559-8267

Other providers in Braintree, MA

All providers in Braintree, MA · Medical Physician Assistant in Massachusetts

Sources for this page

Verify at the official NPI Registry.