Lara Alexis Butler
Physician Assistant in Boston, MA. Individual provider (NPI-1).
NPI number1013377902
StatusActive
Last updated in NPPESDec 15, 2023
Details
- NPI
- 1013377902
- Entity type
- Individual (NPI-1)
- Name
- Lara Alexis Butler
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Mar 4, 2016
- Certification date
- Dec 15, 2023
- Last updated
- Dec 15, 2023
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363A00000X | Physician Assistant | – | – | Yes |
Other names
- Lara Novak (Other Name)
Practice location
75 Francis StBoston, MA 02115-6110
Phone 617-732-8910
Mailing address
450 Brookline AveBoston, MA 02215-5418
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