Individual
RAVI M LALA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
732 HARRISON AVE, PRESTON, 3RD FLOOR, BOSTON, MA 02118-2309
(617) 638-7490
(617) 414-8742
Mailing address
720 HARRISON AVE, DOB 503, BOSTON, MA 02118-2371
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
228922
MA
207RC0000X
Cardiovascular Disease Physician
Primary
228922
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
110074027A
—
MA
Enumeration date
05/26/2006
Last updated
04/25/2014
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