Healthcare Provider Details

I. General information

NPI: 1669779211
Provider Name (Legal Business Name): EOS HEALTH LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/17/2011
Last Update Date: 02/17/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

TEN POST OFFICE SQUARE, 8TH FLOOR
BOSTON MA
02109-4629
US

IV. Provider business mailing address

TEN POST OFFICE SQUARE, 8TH FLOOR PMB#11
BOSTON MA
02109-4629
US

V. Phone/Fax

Practice location:
  • Phone: 888-314-5582
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License Number242801
License Number StateMA
# 2
Primary TaxonomyN
Taxonomy Code207RS0012X
TaxonomySleep Medicine (Internal Medicine) Physician
License Number242801
License Number StateMA
# 3
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number242801
License Number StateMA

VIII. Authorized Official

Name: BHAVNEESH SHARMA
Title or Position: OWNER
Credential: MD
Phone: 718-501-7515