Individual
LAURA SEMINE MISBACH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
840 HARRISON AVE, BOSTON, MA 02118-2905
(617) 638-6610
(617) 638-6616
Mailing address
801 ALBANY ST FL G, BOSTON, MA 02119-3791
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
287025
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
110108751A
—
MA
05
—
3131428
—
NH
Enumeration date
06/18/2015
Last updated
02/16/2022
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