Provider Demographics
NPI:1407892581
Name:PRZYCHODZEN, DOROTHY M (PA)
Entity Type:Individual
Prefix:
First Name:DOROTHY
Middle Name:M
Last Name:PRZYCHODZEN
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:557 COLUMBUS AVE
Mailing Address - Street 2:APT 201
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02118-1154
Mailing Address - Country:US
Mailing Address - Phone:617-650-2106
Mailing Address - Fax:617-975-0919
Practice Address - Street 1:133 BROOKLINE AVE
Practice Address - Street 2:
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02215-3904
Practice Address - Country:US
Practice Address - Phone:617-559-8053
Practice Address - Fax:617-421-3487
Is Sole Proprietor?:No
Enumeration Date:2006-06-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA2036363A00000X, 363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Not Answered363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical