Provider Demographics
NPI:1215105820
Name:MUSOLINO, PATRICIA LEONOR (MD, PHD)
Entity type:Individual
Prefix:DR
First Name:PATRICIA
Middle Name:LEONOR
Last Name:MUSOLINO
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Gender:F
Credentials:MD, PHD
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Mailing Address - Street 1:55 FRUIT ST
Mailing Address - Street 2:WACC 720
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02114
Mailing Address - Country:US
Mailing Address - Phone:617-726-6078
Mailing Address - Fax:617-724-7860
Practice Address - Street 1:55 FRUIT ST
Practice Address - Street 2:WACC 720
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02114
Practice Address - Country:US
Practice Address - Phone:617-726-6093
Practice Address - Fax:617-724-7860
Is Sole Proprietor?:No
Enumeration Date:2008-02-16
Last Update Date:2011-04-15
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Provider Licenses
StateLicense IDTaxonomies
FLTRN 9767208000000X
MA2420952084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
No208000000XAllopathic & Osteopathic PhysiciansPediatrics