Ethan S Agritelley
Student in an Organized Health Care Education/Training Program in Boston, Massachusetts
1003754334- Practice location
- 55 Fruit St, Boston, MA 02114-2621
- Phone
- 617-726-2800
- Fax
- —
- Last updated
- March 25, 2026
Ethan Small Agritelley is a Student in an Organized Health Care Education/Training Program based in Boston, MA. Ethan Small Agritelley practices in Boston, MA. The NPI Number for Ethan Small Agritelley is 1003754334. The current practice location address for Ethan Small Agritelley is 55 Fruit St, Boston, MA 02114-2621 and can be reached out via phone at 617-726-2800.
Provider Profile Details
- NPI Number
- 1003754334
- Provider Name
- Ethan Small Agritelley
- Provider Entity Type
- Individual
- Gender
- Male
- Address
- 55 Fruit St, Boston, MA 02114-2621
- Phone Number
- 617-726-2800
- Primary Taxonomy
- Student in an Organized Health Care Education/Training Program · 390200000X
- Sole Proprietor
- No
- Provider Enumeration Date
- March 25, 2026
- Last Update Date
- March 25, 2026
- Certification Date
- March 25, 2026
- NPI Status
- Active
Provider Business Practice Location Address Details
- Address
- 55 Fruit St
Boston, MA 02114-2621 - City
- Boston
- State
- Massachusetts
- Zip
- 02114-2621
- Phone Number
- 617-726-2800
Provider Business Mailing Address Details
- Address
- 605 W Chapel Hill St Apt 562
Durham, NC 27701-2768 - City
- Durham
- State
- NC
- Zip
- 27701-2768
- Phone Number
- 503-686-5846
- Fax Number
- 503-686-5846
License Information
- Taxonomy
- Student in an Organized Health Care Education/Training Program · 390200000X · Primary
Legacy Identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| No legacy identifiers (Medicaid, Medicare or plan IDs) are on file for this provider. | |||
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Frequently Asked Questions
What is the NPI number of Ethan S Agritelley?
The NPI number of Ethan S Agritelley is 1003754334. It was assigned on March 25, 2026 and is currently active in the NPPES registry.
What is the specialty of Ethan S Agritelley?
Ethan S Agritelley is registered under the primary taxonomy Student in an Organized Health Care Education/Training Program (code 390200000X).
Where does Ethan S Agritelley practice?
The practice location is 55 Fruit St, Boston, MA 02114-2621. The office can be reached at 617-726-2800 (phone).
What is an NPI number?
A National Provider Identifier (NPI) is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS). It is used in HIPAA standard transactions.
How do I verify this NPI record?
This record is sourced from the public NPPES NPI Registry maintained by CMS. You can confirm it by searching NPI 1003754334 directly on the NPPES registry website.