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General NPI Number Information
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NPI Number | 1295710119
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Entity Type | Individual
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Provider Name | ANITA L KOSTECKI M.D.
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Gender | Female
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Dates
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Enumeration Date | 12/14/2005
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Last Update Date | 12/09/2025
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Provider Practice Location Address
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Address Line | 1 BOSTON MEDICAL CTR PL DOWLING 5TH FL
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City | BOSTON
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State | MA
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Zip | 02118-2908
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Country | US
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Telephone | 617-414-4465
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Fax | 617-414-3345
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Provider Business Mailing Address
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Address Line | 960 MASSACHUSETTS AVE STE 2
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City | BOSTON
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State | MA
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Zip | 02118-2690
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Country | US
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Telephone | 617-000-9999
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 78341
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License Number State | MA
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