Provider Demographics
NPI:1316556699
Name:BACALIA, RAY ANTHONY APOLONIO (PA-C)
Entity type:Individual
Prefix:MR
First Name:RAY ANTHONY
Middle Name:APOLONIO
Last Name:BACALIA
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Gender:M
Credentials:PA-C
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Mailing Address - Street 1:70 RIVERPATH DR APT 37
Mailing Address - Street 2:
Mailing Address - City:FRAMINGHAM
Mailing Address - State:MA
Mailing Address - Zip Code:01701-3994
Mailing Address - Country:US
Mailing Address - Phone:973-495-6001
Mailing Address - Fax:
Practice Address - Street 1:55 FRUIT ST
Practice Address - Street 2:
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02114-2621
Practice Address - Country:US
Practice Address - Phone:973-495-6001
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-07-23
Last Update Date:2024-11-13
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Provider Licenses
StateLicense IDTaxonomies
MAPA7605363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant