Healthcare Provider Details

I. General information

NPI: 1588225973
Provider Name (Legal Business Name): BOSTON PELVIC HEALTH AND WELLNESS PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/26/2019
Last Update Date: 06/26/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

62 WALNUT ST FL 2ND
WELLESLEY MA
02481-2113
US

IV. Provider business mailing address

62 WALNUT ST FL 2
WELLESLEY MA
02481-2109
US

V. Phone/Fax

Practice location:
  • Phone: 617-769-2100
  • Fax:
Mailing address:
  • Phone: 617-769-2100
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VF0040X
TaxonomyUrogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. JYOT SAINI
Title or Position: OWNER
Credential: MD
Phone: 617-769-2100