Individual
DR. ELSIE M TAVERAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
300 LONGWOOD AVE, BOSTON, MA 02115-5724
(617) 509-9928
(617) 509-9853
Mailing address
46 WOODARD RD, WEST ROXBURY, MA 02132-2125
(617) 469-3119
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
205164
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
105180
—
MA
Enumeration date
10/03/2006
Last updated
07/08/2007
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