Individual
DR. POOJA MIRA JAYAPRAKASH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1340 BOYLSTON ST, BOSTON, MA 02215-4302
(617) 927-6000
Mailing address
1340 BOYLSTON ST, BOSTON, MA 02215-4302
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
1018070
MA
207Q00000X
Family Medicine Physician
ME154147
FL
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
114673700
—
FL
Enumeration date
03/25/2019
Last updated
07/08/2025
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