Individual
DR. SHUCHI KHOSLA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
80 FENWOOD RD, BOSTON, MA 02115-6120
(617) 732-5056
(617) 738-1275
Mailing address
80 FENWOOD RD, BOSTON, MA 02115-6120
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
292209
MA
2084P0800X
Psychiatry Physician
4301114889
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
292209
STATE LICENSE
MA
Enumeration date
06/25/2018
Last updated
01/09/2023
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