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Individual

MAHASWETA GOOPTU

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
450 BROOKLINE AVE, BOSTON, MA 02215-5418
(617) 632-6000
Mailing address
925 CHESTNUT ST, SUITE 320A, PHILADELPHIA, PA 19107-4216

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
272299
MA
207RH0000X
Hematology (Internal Medicine) Physician
272299
MA
207RX0202X
Medical Oncology Physician
Primary
272299
MA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0311049
NJ
05
102767064
PA
Enumeration date
08/27/2009
Last updated
03/17/2018
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