Provider Demographics
NPI:1720706690
Name:PESCETTO, CAMILA PATRICIA
Entity Type:Individual
Prefix:
First Name:CAMILA
Middle Name:PATRICIA
Last Name:PESCETTO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:860 BEACON ST APT 703
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02215-3124
Mailing Address - Country:US
Mailing Address - Phone:774-444-1002
Mailing Address - Fax:
Practice Address - Street 1:1 BOSTON MEDICAL CTR PL STE 1
Practice Address - Street 2:
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02118-2999
Practice Address - Country:US
Practice Address - Phone:617-638-8000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-17
Last Update Date:2022-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program