Individual
IFE JAHA TRACY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
960 MASSACHUSETTS AVE # 3448-A, BOSTON UNIVERSITY FAMILY MEDICINE;VALUE BASED PROGRAM, BOSTON, MA 02118-2620
(617) 414-2080
Mailing address
960 MASSACHUSETTS AVE STE 2, BOSTON, MA 02118-2690
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN2299747
MA
363LF0000X
Family Nurse Practitioner
Primary
RN2299747
MA
Other
Enumeration date
07/13/2020
Last updated
08/23/2024
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