Individual
TINA BANZON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
300 LONGWOOD AVE, BOSTON, MA 02115-5724
(617) 355-6000
Mailing address
300 LONGWOOD AVE, BOSTON, MA 02115-5724
Taxonomy
Speciality
Code
Description
License number
State
2080P0201X
Pediatric Allergy/Immunology Physician
Primary
291994
MA
Other
Enumeration date
02/12/2018
Last updated
05/25/2022
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