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General NPI Number Information
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NPI Number | 1366753642
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Entity Type | Individual
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Provider Name | RADHIKA S DATAR MD
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Gender | Female
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Dates
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Enumeration Date | 07/01/2010
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Last Update Date | 05/06/2025
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Provider Practice Location Address
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Address Line | 850 HARRISON AVE FL 4YAWKEY
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City | BOSTON
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State | MA
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Zip | 02118-4001
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Country | US
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Telephone | 617-414-2000
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Fax |
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Provider Business Mailing Address
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Address Line | 960 MASSACHUSETTS AVENUE FL 2
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City | BOSTON
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State | MA
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Zip | 02118
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | 53395
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License Number State | CT
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Taxonomy #2
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Taxonomy Code | 207VX0000X
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Taxonomy Name | Obstetrics Physician
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License Number | 1016727
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License Number State | MA
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