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DR. TRISTAN GREGORY KOOISTRA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
55 FRUIT ST, BOSTON, MA 02114-2621
(617) 724-9674
Mailing address
55 FRUIT STREET, MGH PULMONARY - BUL 148, BOSTON, MA 02114
(617) 724-9674

Taxonomy

Speciality
Code
Description
License number
State
207RP1001X
Pulmonary Disease Physician
Primary
276793
MA
390200000X
Student in an Organized Health Care Education/Training Program
256529
MA

Other

Enumeration date
06/11/2013
Last updated
04/10/2019
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