Healthcare Provider Details

I. General information

NPI: 1194790220
Provider Name (Legal Business Name): DEVANSHI PATEL MS
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 02/22/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

55 FRUIT ST YAWKEY 9A
BOSTON MA
02114-2621
US

IV. Provider business mailing address

1213 BEACON ST APARTMENT 8
BROOKLINE MA
02446-5393
US

V. Phone/Fax

Practice location:
  • Phone: 617-724-3285
  • Fax: 617-726-9418
Mailing address:
  • Phone: 617-921-2895
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code170300000X
TaxonomyGenetic Counselor (M.S.)
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: