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Individual

RAJNEESH S HAZARIKA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
10 GOVE ST, EAST BOSTON, MA 02128-1920
(617) 569-5800
(617) 568-4780
Mailing address
10 GOVE ST, EAST BOSTON, MA 02128-1920
(617) 569-5800
(617) 568-4780

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
230178
MA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1319833
MA
01
221845
UGS
MA
01
J42315
BLUE SHIELD OF MA
MA
Enumeration date
09/12/2006
Last updated
10/21/2016
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