Individual
DR. GANESHWARAN H MOCHIDA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
55 FRUIT ST, YAW 6 PEDIATRIC NEUROLOGY, BOSTON, MA 02114-2621
(617) 726-3402
(617) 724-7866
Mailing address
PO BOX 9142, MASS GENERAL PHYSICIAN ORGANIZATION, CHARLESTOWN, MA 02129-9142
(617) 724-0287
(617) 726-2894
Taxonomy
Speciality
Code
Description
License number
State
2084N0402X
Neurology with Special Qualifications in Child Neurology Physician
Primary
159455
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
159455
TUFTS HEALTH PLAN
MA
01
—
J24907
BCBS MA
MA
Enumeration date
12/02/2005
Last updated
01/10/2011
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