Provider Demographics
NPI:1619671856
Name:OFLANAGAN, GRACE ANNE (MCH MB BAO BCOMM)
Entity Type:Individual
Prefix:MS
First Name:GRACE
Middle Name:ANNE
Last Name:OFLANAGAN
Suffix:
Gender:F
Credentials:MCH MB BAO BCOMM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 LONGWOOD AVENUE
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02115
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:300 LONGWOOD AVENUE
Practice Address - Street 2:
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02115
Practice Address - Country:US
Practice Address - Phone:617-355-6462
Practice Address - Fax:317-730-0337
Is Sole Proprietor?:No
Enumeration Date:2023-03-30
Last Update Date:2023-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program