Individual
SAMANTHA DROHAN BETTI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN, PNP
Contact information
Practice address
801 MASSACHUSETTS AVE., CROSSTOWN BLDG FL 7, BOSTON, MA 02118
(617) 414-4841
Mailing address
BMC PROVIDER ENROLLMENT OFFICE, 960 MASSACHUSETTS AVE,.2ND FLOOR, BOSTON, MA 02122
(617) 414-5405
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
233173
MA
Other
Enumeration date
04/20/2016
Last updated
04/04/2024
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