Individual
DR. AMITABH SRIVASTAVA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
75 FRANCIS STREET, AMORY 3, BOSTON, MA 02115
(617) 732-7510
(617) 264-5118
Mailing address
75 FRANCIS STREET, AMORY 3, BOSTON, MA 02115
(617) 732-7510
(617) 264-5118
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
219855
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2101866
—
MA
01
—
468390
TUFTS HEALTH PLAN
MA
01
—
J28666
BCBS MA
MA
Enumeration date
10/26/2005
Last updated
12/16/2021
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