Provider Demographics
NPI:1730562588
Name:HART, ELSPETH ASHLEY VANOSSENBRUGGEN (PA-C, ATC)
Entity type:Individual
Prefix:MS
First Name:ELSPETH ASHLEY
Middle Name:VANOSSENBRUGGEN
Last Name:HART
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Gender:F
Credentials:PA-C, ATC
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Mailing Address - Street 1:300 LONGWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02115-5724
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:300 LONGWOOD AVE
Practice Address - Street 2:
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02115-5724
Practice Address - Country:US
Practice Address - Phone:617-355-6000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-06-29
Last Update Date:2022-03-04
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Provider Licenses
StateLicense IDTaxonomies
MAPA5464363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant