Basic Information
| Provider Information | |||||||||
| NPI: | 1598702607 | ||||||||
| EntityType: | 1 | ||||||||
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| LastName: | JOLESZ | ||||||||
| FirstName: | ANNA | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 400 SHAWMUT AVE | ||||||||
| Address2: | SOUTH END COMMUNITY HLTH CENT. | ||||||||
| City: | BOSTON | ||||||||
| State: | MA | ||||||||
| PostalCode: | 021182006 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6174252000 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1601 WASHINGTON ST | ||||||||
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| City: | BOSTON | ||||||||
| State: | MA | ||||||||
| PostalCode: | 021181951 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6174252000 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 05/31/2006 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | X | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208000000X | 48803 | MA | Y | Allopathic & Osteopathic Physicians | Pediatrics |
No ID Information.