Individual provider · Type 1 NPI

Erica Cordelle Thibeault, PA-C

Surgical Physician Assistant · Boston, MA

NPI number 1124547625 Active

Practice location

300 Longwood Ave
Boston, MA 02115-5724

Call (617) 355-7648 Map

Mailing address

47 Colborne Rd Apt B2
Brighton, MA 02135-4112

Specialties and licenses

TaxonomyCodeLicense
Surgical Physician Assistant Primary 363AS0400XPA6205 (MA)

Surgical Physician Assistant: Definition to come...

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About NPI 1124547625

Erica Cordelle Thibeault, PA-C's National Provider Identifier is 1124547625, issued on Sep 15, 2017. The primary taxonomy on file is Surgical Physician Assistant (363AS0400X), and the practice location is in Boston, MA. The record was last updated on Sep 15, 2017.