Individual
AVANI SHAH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
55 FRUIT ST, BOSTON, MA 02114
(617) 726-7640
Mailing address
55 FRUIT ST, BOSTON, MA 02114-2696
(212) 860-6631
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
RN2320595
MA
363LA2100X
Acute Care Nurse Practitioner
430831
NY
363LA2100X
Acute Care Nurse Practitioner
RN2320595
MA
Other
Enumeration date
11/11/2014
Last updated
10/12/2018
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