Most Relevant Information
Provider Data
| NPI Number: | 1003473273 |
| Provider Name: | KEVIN YAN KOENDERS PA-C |
| Entity Type: | Individual |
| Taxonomy Code: | 363A00000X |
| Specialty: | Physician Assistant |
| License Number: | PA7466 |
Most Important Dates
| Enumeration Date: | 05/23/2019 |
| Last Updated: | 03/26/2021 |
Provider Practice Location
2014 WASHINGTON ST
DEPARTMENT OF ORTHOPEDICS
NEWTON
MA
024621607
Practice Location Phone/Fax
| Phone: | 6172191674 |
| Fax: |
Provider Mailing Location
PO BOX 415348
BOSTON
MA
022415348
Provider Mailing Phone/Fax
| Phone: | 8002258885 |
| Fax: | 5083341977 |