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Individual

MILANA STAVITSKY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
422 WORCESTER ST, SUITE 103-105, WELLESLEY, MA 02481
(781) 235-9737
(781) 235-9738
Mailing address
422 WORCESTER ST, SUITE 103-105, WELLESLEY, MA 02481
(781) 235-9737
(781) 235-9738

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
78887
MA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
20-1792042
TAX ID
MA
01
200995
HARVARD PILGRIM
05
3149811
MA
01
402449
TUFTS
MA
01
C31654
BCBS
01
M19207
BCBS
MA
Enumeration date
01/25/2006
Last updated
01/23/2012
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