Jonathan Vandale
Sports Medicine Orthopaedic Surgeon
60 Fenwood Rd Fl 2
Boston
, Massachusetts 02115-6128
Jonathan Vandale
Sports Medicine Orthopaedic Surgeon
60 Fenwood Rd Fl 2
Boston
, Massachusetts 02115-6128
(413) 262-9376
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About
Features
Specialties
- Sports Medicine Orthopaedic Surgeon
Languages spoken
- English
Location
First Address
- Jonathan Vandale
- 831 E 2nd St # 2
- South Boston, MA
- Zip : 02127-2333
- Phone : (413) 262-9376
Second Address
- Jonathan Vandale
- 60 Fenwood Rd Fl 2
- Boston, MA
- Zip : 02115-6128
- Phone : (617) 732-5322
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 207XX0005X | Sports Medicine Orthopaedic Surgeon | PA6762 | MA |
National Provider Identifier
| NPI | 1154805281 |
|---|---|
| Provider Name | Jonathan Vandale |
| First Address | South Boston, MA 02127-2333 |
| Second Address | Boston, MA 02115-6128 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 25/09/2018 |
| Last Update Date | 25/09/2018 |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.