Antonelli, Richard

Antonelli, Richard is an individual health care provider with primary practice located at 300 Longwood Ave Children'S Hospital Boston Primary Care Center, Boston MA 02115-5724. He recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as his primary health care specialty. Antonelli, Richard can be contacted via phone (617) 355-7701.

Contact Information

Primary practice address
300 Longwood Ave Children'S Hospital Boston Primary Care Center Boston MA 02115-5724
Phone: (617) 355-7701
Fax: (617) 730-0505
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 043502 Connecticut

Profile Details

NPI number 1275505786
LBN Legal business name Antonelli, Richard
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 7th, 2006
Last updated Feb 11th, 2009 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1275505786 NPPES
Connecticut MEDICAID 001435024

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