Individual
DR. ITAI MAX PASHTAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
75 FRANCIS ST, L2, BOSTON, MA 02115-6110
(617) 732-6230
(617) 582-6037
Mailing address
75 FRANCIS ST, L2, BOSTON, MA 02115-6110
(617) 732-6230
(617) 582-6037
Taxonomy
Speciality
Code
Description
License number
State
2085R0001X
Radiation Oncology Physician
Primary
246073
MA
282N00000X
General Acute Care Hospital
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
125054409
ILLINOIS DEPARTMENT OF FINANCIAL AND PROFESSIONAL REGULATION
IL
Enumeration date
06/27/2008
Last updated
05/18/2012
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