Healthcare Provider Details

I. General information

NPI: 1851358279
Provider Name (Legal Business Name): ELVIRA ARONZON PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/28/2006
Last Update Date: 02/10/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

237 HAMPSHIRE ST
CAMBRIDGE MA
02139-1306
US

IV. Provider business mailing address

237 HAMPSHIRE ST
CAMBRIDGE MA
02139-1306
US

V. Phone/Fax

Practice location:
  • Phone: 617-575-5570
  • Fax: 617-876-0217
Mailing address:
  • Phone: 617-575-5570
  • Fax: 617-876-0217

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA2456
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: