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NPI Code Detail

MEDICARE: VASSO ANEST KUMARELAS PA-C

MEDICARE: VASSO ANEST KUMARELAS PA-C
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363AM0700XMedical Physician AssistantPA1688NV
2363AM0700XMedical Physician AssistantMA6390MA

General Provider Information

NPI Number : 1477910537
Entity Type Code : Individual
Provider Name (Legal Business Name) : VASSO ANEST KUMARELAS PA-C
Provider Business Mailing Address
First Line : 1720 W HORIZON RIDGE PKWY STE 140
Second Line :
City : HENDERSON
State : NV
Zip : 89012-4896
Country : US
Telephone Number : 702-566-5445
Fax Number : 702-566-5035
Provider Business Practice Location Address
First Line : 1285 BEACON ST
Second Line :
City : BROOKLINE
State : MA
Zip : 02446-5237
Country : US
Telephone Number : 617-751-6205
Fax Number : 617-487-8663
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/20/2016
Last Update Date : 03/02/2020

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Directions to “ VASSO ANEST KUMARELAS PA-C” Practice Location

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