Individual
MRS. DIANE GISELLE KANJILAL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
55 FRUIT ST # 504F, BOSTON, MA 02114-2696
(617) 643-9958
Mailing address
55 FRUIT ST # 504F, BOSTON, MA 02114-2696
(617) 643-9958
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
RN2310852
MA
363L00000X
Nurse Practitioner
RN2310852
MA
Other
Enumeration date
11/24/2021
Last updated
01/06/2022
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