IndividualActive
Brian Boudreau, PA-C
NPI 1417352816 · Surgical Physician Assistant · Boston, MA
Provider details
- NPI number
- 1417352816
- Entity type
- Individual
- Primary specialty
- Surgical Physician AssistantPhysician Assistants & Advanced Practice Nursing Providers
- Credential
- PA-C
- Sex
- Male
- Sole proprietor
- Yes
- License
- PA5161 (MA)
Specialties & taxonomies
Physician Assistants & Advanced Practice Nursing Providers
Practice location
300 Longwood Ave
Department of Otolaryngology
Boston, MA 02115-5724
Phone: (617) 355-6460
Approximate (ZIP-level) locationGet directions
Mailing address
300 Longwood Ave
Boston, MA 02115-5724
Registry dates
- Enumerated
- 2014-10-28
- Last updated
- 2014-10-28
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.