Colucci, Wilson S

Colucci, Wilson S is an individual health care provider with primary practice located at 732 Harrison Ave 3Rd Floor, Boston MA 02118-2309. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Cardiovascular Disease, Allopathic & Osteopathic Physicians / Internal Medicine. Allopathic & Osteopathic Physicians / Cardiovascular Disease is his primary health care specialty. Colucci, Wilson S can be contacted via phone (617) 638-7490.

Contact Information

Primary practice address
732 Harrison Ave 3Rd Floor Boston MA 02118-2309
Phone: (617) 638-7490
Fax: (617) 414-8742
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Cardiovascular Disease 207RC0000X 44944 Massachusetts
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X 44944 Massachusetts

Profile Details

NPI number 1588629505
LBN Legal business name Colucci, Wilson S
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 20th, 2006
Last updated Jul 24th, 2014 - about 12 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 1588629505 NPPES
Massachusetts MEDICAID 110003480A

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