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NPI Code Detail

MEDICARE: SAMANTHA AGGOURAS PA-C

MEDICARE: SAMANTHA AGGOURAS 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
1363A00000XPhysician AssistantPA7694MA

General Provider Information

NPI Number : 1770196396
Entity Type Code : Individual
Provider Name (Legal Business Name) : SAMANTHA AGGOURAS PA-C
Provider Business Mailing Address
First Line : 75 FRANCIS ST
Second Line :
City : BOSTON
State : MA
Zip : 02115-6110
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 75 FRANCIS ST
Second Line :
City : BOSTON
State : MA
Zip : 02115-6110
Country : US
Telephone Number : 617-732-6824
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/24/2020
Last Update Date : 03/06/2026

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Directions to “ SAMANTHA AGGOURAS PA-C” Practice Location

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