Individual
SCHARUKH JALISI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D., MA
Contact information
Practice address
330 BROOKLINE AVE, BOSTON, MA 02215-5400
(617) 732-7500
(617) 638-7522
Mailing address
720 HARRISON AVE, DOB 503, BOSTON, MA 02118-2371
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
223941
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2104792
—
MA
Enumeration date
04/03/2006
Last updated
05/04/2024
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