Jorge Anthony Bacallao
Jorge Anthony Bacallao is a Student in an Organized Health Care Education/Training Program in Boston, Massachusetts. Practices as a sole proprietor. Registered with an NPI since 2024.
- In the registry since
- 2024
Practice location Address checks out
1 Kneeland StBoston, MA 02111-1527
Phone: (617) 636-6828
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Specialties & licences
| Student in an Organized Health Care Education/Training Program (primary) | Taxonomy 390200000X |
|---|
Record details
| NPI number | 1598502825 |
|---|---|
| Entity type | Individual (Type 1) |
| Gender | Male |
| Sole proprietor | Yes |
| NPI enumerated | July 12, 2024 |
| Last updated in NPPES | July 12, 2024 |
| Certification date | July 12, 2024 |
| Mailing address | 1 Kneeland St, Boston, MA 02111-1527 |
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