Individual
DIVYA SAHORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
136 HARRISON AVE STE 207, BOSTON, MA 02111-1817
(617) 636-0405
Mailing address
96 SUMMER ST, MEDFORD, MA 02155-4434
(781) 775-4902
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
Other
Enumeration date
02/20/2020
Last updated
02/20/2020
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