Organization
PEDIATRIC PULMONARY SPECIALISTS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
VIRGINIA S KHARASCH MD (PRESIDENT)
(617) 783-0475
Entity
Organization
Contact information
Practice address
30 WARREN STREET, BRIGHTON, MA 02135
(617) 783-0475
(617) 779-1239
Mailing address
PO BOX 35825, BRIGHTON, MA, MA 02135
(617) 783-0475
(617) 779-1239
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
—
—
2080P0214X
Pediatric Pulmonology Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1477553923
INDIVIDUAL NPI NUMBER
MA
05
—
3055736
—
MA
05
—
9781056
—
MA
Enumeration date
05/03/2007
Last updated
09/11/2025
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