Provider Demographics
NPI:1639664980
Name:MUSURAKIS, CLIO (MD)
Entity Type:Individual
Prefix:
First Name:CLIO
Middle Name:
Last Name:MUSURAKIS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:LOWRY MEDICAL OFFICES BUILDING 110 FRANCIS STREET
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02215
Mailing Address - Country:US
Mailing Address - Phone:617-667-9344
Mailing Address - Fax:617-667-7060
Practice Address - Street 1:LOWRY MEDICAL OFFICES BUILDING 110 FRANCIS STREET
Practice Address - Street 2:
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02215-3328
Practice Address - Country:US
Practice Address - Phone:617-667-9344
Practice Address - Fax:617-667-7060
Is Sole Proprietor?:No
Enumeration Date:2018-06-28
Last Update Date:2023-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1014638207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism