Bolton Street Pediatrics PC

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

59542 Issued in MA

Legal business name

BOLTON STREET PEDIATRICS PC

Practice address

320 Bolton St
Marlborough, MA 01752-3988

Phone

(508) 460-9670

Fax

(508) 460-0357

NPI assigned

Jan 3, 2013

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Odette Solla Cabrera, MD

Title

President

Phone

(508) 460-9670

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1357171200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1357171200000",
    "number": "1336486869",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "320 BOLTON ST",
            "city": "MARLBOROUGH",
            "state": "MA",
            "postal_code": "017523988",
            "telephone_number": "508-460-9670",
            "fax_number": "508-460-0357"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "320 BOLTON ST",
            "city": "MARLBOROUGH",
            "state": "MA",
            "postal_code": "017523988",
            "telephone_number": "508-460-9670",
            "fax_number": "508-460-0357"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BOLTON STREET PEDIATRICS PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-01-03",
        "last_updated": "2013-01-03",
        "status": "A",
        "authorized_official_last_name": "SOLLA CABRERA",
        "authorized_official_first_name": "ODETTE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "508-460-9670",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": "MA",
            "license": "59542",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kwasi Karikari Boateng
• Jacilyn Boddy
• McHelle Bodin-Hettinger, LICSW
• Body Dynamics Nutrition
• Vennessa Marie Bolden
• Sofia Evelyn Bon Tempo, B.S.
• Patricia Bonanno
• Samantha Bonet
• Lisbeth Bonilla
• Maame Serwah Bonsu Addo, BA

• Pediatrics Physician in Marlborough, MA
• Providers in Marlborough, MA by specialty
• Pediatrics Physician in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.