Individual
AVA BAKHTYARI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
725 ALBANY STREET, SUITE 7B, SHAPIRO BLDG., BOSTON, MA 02118
(617) 638-8456
(617) 638-8465
Mailing address
960 MASSACHUSETTS AVENUE, FL 2, BOSTON, MA 02118-2690
Taxonomy
Speciality
Code
Description
License number
State
2084N0008X
Neuromuscular Medicine (Psychiatry & Neurology) Physician
1018850
MA
2084N0400X
Neurology Physician
Primary
1018850
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
110166448A
—
MA
05
—
3150920
—
NH
Enumeration date
03/25/2020
Last updated
10/28/2025
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