Healthcare Provider Details

I. General information

NPI: 1619363330
Provider Name (Legal Business Name): TINA JUMANI DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/09/2015
Last Update Date: 03/05/2025
Certification Date: 03/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

MASS GENERAL HOSPITAL 55 FRUIT STREET
BOSTON MA
02115
US

IV. Provider business mailing address

330 MOUNT AUBURN ST # 2
CAMBRIDGE MA
02138-5597
US

V. Phone/Fax

Practice location:
  • Phone: 617-724-4133
  • Fax:
Mailing address:
  • Phone: 617-499-5595
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number274260
License Number StateMA
# 2
Primary TaxonomyY
Taxonomy Code2080N0001X
TaxonomyNeonatal-Perinatal Medicine Physician
License Number274260
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: