Healthcare Provider Details

I. General information

NPI: 1629424700
Provider Name (Legal Business Name): AISHATU I. LADU MD, MPH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: AISHATU L ALOMA

II. Dates (important events)

Enumeration Date: 05/09/2016
Last Update Date: 03/12/2025
Certification Date: 03/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

736 CAMBRIDGE ST
BRIGHTON MA
02135-2907
US

IV. Provider business mailing address

960 MASSACHUSETTS AVENUE FL 2
BOSTON MA
02118-2690
US

V. Phone/Fax

Practice location:
  • Phone: 617-789-3000
  • Fax: 617-789-3015
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207ZC0500X
TaxonomyCytopathology Physician
License Number282239
License Number StateMA
# 2
Primary TaxonomyY
Taxonomy Code207ZP0102X
TaxonomyAnatomic Pathology & Clinical Pathology Physician
License Number282239
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: