Individual
JYOTHI RAVINDRA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1493 CAMBRIDGE ST, CAMBRIDGE, MA 02139-1047
(617) 591-6300
Mailing address
1493 CAMBRIDGE ST, CAMBRIDGE, MA 02139-1047
(617) 591-6300
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
272932
MA
390200000X
Student in an Organized Health Care Education/Training Program
259698
MA
Other
Enumeration date
05/06/2014
Last updated
12/06/2017
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