Individual
DR. DEBRA D POUTSIAKA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD, PHD
Contact information
Practice address
750 WASHINGTON ST, TUFTS-NEW ENGLAND MEDICAL CENTER, BOX 041, BOSTON, MA 02111-1526
(617) 636-7005
(617) 636-8525
Mailing address
750 WASHINGTON ST, TUFTS-NEW ENGLAND MEDICAL CENTER, BOX 041, BOSTON, MA 02111
(617) 636-7005
(617) 636-8525
Taxonomy
Speciality
Code
Description
License number
State
207RI0200X
Infectious Disease Physician
Primary
76031
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1213288
MASSHEALTH
MA
Enumeration date
07/12/2006
Last updated
07/08/2007
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