Individual
DR. BARSAM KASRAVI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
75 BICKFORD ST, JAMAICA PLAIN, MA 02130-1401
(617) 971-2100
Mailing address
235 PARK DR, APT #38, BOSTON, MA 02215-4745
(310) 968-9989
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
222774
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
J28549
BLUE CROSS
MA
Enumeration date
09/20/2006
Last updated
07/08/2007
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