IndividualActive
Jonathan Vandale, PA-C
NPI 1154805281 · Sports Medicine (Orthopaedic Surgery) Physician · Boston, MA
Provider details
- NPI number
- 1154805281
- Entity type
- Individual
- Primary specialty
- Sports Medicine (Orthopaedic Surgery) PhysicianAllopathic & Osteopathic Physicians
- Credential
- PA-C
- Sex
- Male
- Sole proprietor
- No
- License
- PA6762 (MA)
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Practice location
60 Fenwood Rd Fl 2
Boston, MA 02115-6128
Phone: (617) 732-5322
Approximate (ZIP-level) locationGet directions
Mailing address
831 E 2nd St # 2
South Boston, MA 02127-2333
Registry dates
- Enumerated
- 2018-09-25
- Last updated
- 2018-09-25
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.