Individual
JALEH MANSOURI
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
330 BROOKLINE AVE, BETH ISRAEL DEACONESS MED CTR, BOSTON, MA 02215-5400
(617) 632-7243
Mailing address
400 BROOKLINE AVE, APT. 11 D, BOSTON, MA 02215-5408
(617) 632-7243
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
225334
MA
Other
Enumeration date
05/31/2006
Last updated
07/08/2007
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