Healthcare Provider Details

I. General information

NPI: 1245709518
Provider Name (Legal Business Name): ISRA HASHMI CNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/16/2018
Last Update Date: 11/16/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

165 CAMBRIDGE ST STE 404
BOSTON MA
02114-2750
US

IV. Provider business mailing address

18 DALE ST UNIT 8B
ANDOVER MA
01810-5664
US

V. Phone/Fax

Practice location:
  • Phone: 617-726-2217
  • Fax:
Mailing address:
  • Phone: 617-308-6188
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberRN2308780
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: