Individual
DR. MAITREYI MAZUMDAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
300 LONGWOOD AVE, BOSTON, MA 02115-5724
(617) 355-2918
Mailing address
37 BIGELOW ST, CAMBRIDGE, MA 02139-2301
(617) 864-5389
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
208112
MA
2084N0400X
Neurology Physician
208112
MA
2084N0402X
Neurology with Special Qualifications in Child Neurology Physician
Primary
208112
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2117312
—
MA
Enumeration date
12/21/2006
Last updated
07/28/2008
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