Individual
MUMTU SUNIL LALLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
800 WASHINGTON ST, BOSTON, MA 02111-1552
(617) 636-5246
Mailing address
111 E 210TH ST, BRONX, NY 10467-2401
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
279959
MA
Other
Enumeration date
04/17/2019
Last updated
04/18/2023
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