Individual
GOURI DATTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
41 MALL RD, BURLINGTON, MA 01805-0001
(332) 334-0886
(781) 744-5235
Mailing address
41 MALL RD, LAHEY CLINIC, INC., BURLINGTON, MA 01805-0001
(332) 334-0886
(781) 744-5235
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
38554
MA
2084P0800X
Psychiatry Physician
Primary
38554
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3037754
—
MA
Enumeration date
09/22/2005
Last updated
04/17/2026
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