Healthcare Provider Details

I. General information

NPI: 1114422110
Provider Name (Legal Business Name): NATALYA SURMACHEVSKA DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/29/2018
Last Update Date: 06/30/2026
Certification Date: 06/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

725 ALBANY STREET, SUITE 8A SHAPIRO BLDG
BOSTON MA
02118-2526
US

IV. Provider business mailing address

960 MASSACHUSETTS AVE FL 2
BOSTON MA
02118-5526
US

V. Phone/Fax

Practice location:
  • Phone: 617-638-7460
  • Fax: 617-638-7454
Mailing address:
  • Phone: 617-414-5405
  • Fax: 617-414-6031

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RR0500X
TaxonomyRheumatology Physician
License Number1020344
License Number StateMA
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number1020344
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: