Individual
MS. SAVATRI TACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
1200 CENTRE STREET, DEPARTMENT OF MEDICINE, ROSLINDALE, MA 02131-1000
(617) 363-8010
(617) 363-8929
Mailing address
1200 CENTRE STREET, DEPARTMENT OF MEDICINE, ROSLINDALE, MA 02131-1000
(617) 363-8010
(617) 363-8929
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
207349
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
110088213A
—
MA
01
—
1974901
MEDICARE
MA
Enumeration date
11/11/2010
Last updated
07/02/2015
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