Individual
SOURBHA SATISH DANI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
LAHEY HOSPITAL AND MEDICAL CENTER, 41 MALL ROAD, BURLINGTON, MA 01805
(781) 744-8000
Mailing address
PROVIDER ENROLLMENT DEPARTMENT, 41 MALL ROAD, BURLINGTON, MA 01805
(781) 744-8085
(781) 744-5433
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
236109
MA
207RC0000X
Cardiovascular Disease Physician
Primary
248170
MA
207RC0000X
Cardiovascular Disease Physician
MD20447
ME
207RC0001X
Clinical Cardiac Electrophysiology Physician
MD20447
ME
Other
Enumeration date
09/18/2008
Last updated
10/08/2019
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