Healthcare Provider Details

I. General information

NPI: 1881114759
Provider Name (Legal Business Name): ADITI VIAN VARMA M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/22/2017
Last Update Date: 12/21/2025
Certification Date: 12/21/2025
Deactivation Date: 01/26/2018
Reactivation Date: 02/13/2018

III. Provider practice location address

75 FRANCIS ST
BOSTON MA
02115-6110
US

IV. Provider business mailing address

75 FRANCIS ST
BOSTON MA
02115-6110
US

V. Phone/Fax

Practice location:
  • Phone: 617-732-7432
  • Fax:
Mailing address:
  • Phone: 617-732-7432
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number338608
License Number StateLA
# 2
Primary TaxonomyY
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number286996
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: