Individual
SORAVIS OSATAPHAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
330 BROOKLINE AVE, BOSTON, MA 02215-5400
(617) 499-5639
Mailing address
330 BROOKLINE AVE, BOSTON, MA 02215-5400
(857) 707-5195
Taxonomy
Speciality
Code
Description
License number
State
207RH0000X
Hematology (Internal Medicine) Physician
1023906
MA
207RH0003X
Hematology & Oncology Physician
1023906
MA
207RX0202X
Medical Oncology Physician
Primary
1023906
MA
Other
Enumeration date
04/30/2019
Last updated
10/08/2025
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