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Individual

PRAVEEN GOVENDER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
725 ALBANY STREET, SHAPIRO 9, SUITE B, BOSTON, MA 02118-2526
(617) 638-7480
(617) 638-7486
Mailing address
720 HARRISON AVE, DOB 5, BOSTON, MA 02118-4001

Taxonomy

Speciality
Code
Description
License number
State
207K00000X
Allergy & Immunology Physician
251164
MA
207RP1001X
Pulmonary Disease Physician
Primary
251164
MA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
110092827A
MA
Enumeration date
08/23/2008
Last updated
10/17/2017
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