Individual
LIRAN DOMACHEVSKY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
375 BOYLSTON ST, BROOKLINE, MA 02445-6007
(857) 307-0849
Mailing address
29 BARTLETT CRESCENT APT 2, BROOKLINE, MA 02446
(617) 529-2093
Taxonomy
Speciality
Code
Description
License number
State
2085N0904X
Nuclear Radiology Physician
Primary
248431
MA
Other
Enumeration date
07/16/2012
Last updated
07/16/2012
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