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Individual

MISS PREETI SUBRAMANYA SHASTRI

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
330 BROOKLINE AVE, STONEMAN 10, BOSTON, MA 02215-5400
(617) 667-3940
Mailing address
330 BROOKLINE AVE, STONEMAN 10, BOSTON, MA 02215-5400
(617) 667-3940

Taxonomy

Speciality
Code
Description
License number
State
2081S0010X
Sports Medicine (Physical Medicine & Rehabilitation) Physician
Primary
252866
MA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1720228117
MA
05
1720228117
MO
Enumeration date
02/25/2009
Last updated
10/25/2013
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