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General NPI Number Information
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NPI Number | 1699765867
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Entity Type | Individual
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Provider Name | MEERA MAHALINGAM M.D.
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Gender | Female
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Dates
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Enumeration Date | 10/27/2005
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Last Update Date | 10/05/2020
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Provider Practice Location Address
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Address Line | 1400 VFW PKWY DEPT OF
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City | WEST ROXBURY
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State | MA
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Zip | 02132-4927
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Country | US
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Telephone | 857-203-5992
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Fax |
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Provider Business Mailing Address
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Address Line | 104 COOLIDGE ST
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City | BROOKLINE
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State | MA
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Zip | 02446-5808
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Country | US
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Telephone | 617-251-8369
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Fax | 508-334-5374
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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 | 207ZP0101X
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Taxonomy Name | Anatomic Pathology Physician
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License Number | 154499
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License Number State | MA
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Taxonomy #2
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Taxonomy Code | 207ZP0102X
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Taxonomy Name | Anatomic Pathology & Clinical Pathology Physician
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License Number | 154499
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License Number State | MA
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