Individual
MIRA A BAJAJ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
55 FRUIT ST, BOSTON, MA 02114-2621
(410) 955-5000
Mailing address
55 FRUIT ST, BOSTON, MA 02114-2621
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
3016314
MA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
01/10/2022
Last updated
04/12/2024
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