Individual
SUBHA BAISYAT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
34 N PEARL ST, BROCKTON, MA 02301-1708
(508) 408-9200
(857) 241-5492
Mailing address
960 MASSACHUSETTS AVE, FL 2, BOSTON, MA 02118
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
278218
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
110154453A
—
MA
Enumeration date
06/22/2015
Last updated
12/18/2023
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