Healthcare Provider Details
I. General information
NPI: 1265979421
Provider Name (Legal Business Name): MEHTAP HAKTANIR ABUL M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 01/26/2017
Last Update Date: 08/18/2025
Certification Date: 08/18/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
330 BROOKLINE AVE
BOSTON MA
02215-5400
US
IV. Provider business mailing address
593 EDDY ST
PROVIDENCE RI
02903-4923
US
V. Phone/Fax
- Phone: 617-667-7000
- Fax:
- Phone: 401-444-8805
- Fax: 401-444-2988
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 208000000X |
| Taxonomy | Pediatrics Physician |
| License Number | MD18474 |
| License Number State | RI |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2080P0214X |
| Taxonomy | Pediatric Pulmonology Physician |
| License Number | MD18474 |
| License Number State | RI |
| # 3 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207RS0012X |
| Taxonomy | Sleep Medicine (Internal Medicine) Physician |
| License Number | 270846 |
| License Number State | MA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: