Provider Demographics
NPI:1710461884
Name:ANASTOPOULOS, MARINA CECILIA (MS, PA-C)
Entity Type:Individual
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First Name:MARINA
Middle Name:CECILIA
Last Name:ANASTOPOULOS
Suffix:
Gender:F
Credentials:MS, PA-C
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Mailing Address - Street 1:213 HANOVER ST APT 3
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02113-2313
Mailing Address - Country:US
Mailing Address - Phone:781-686-4088
Mailing Address - Fax:
Practice Address - Street 1:LAHEY HOSPITAL AND MEDICAL CENTER
Practice Address - Street 2:41 MALL ROAD
Practice Address - City:BURLINGTON
Practice Address - State:MA
Practice Address - Zip Code:01805-0001
Practice Address - Country:US
Practice Address - Phone:781-744-8085
Practice Address - Fax:781-744-5433
Is Sole Proprietor?:Yes
Enumeration Date:2018-09-24
Last Update Date:2019-01-04
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MAPA6759363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant