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General NPI Number Information
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NPI Number | 1942762380
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Entity Type | Individual
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Provider Name | ANISHA GUNDEWAR MD
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Gender | Female
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Dates
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Enumeration Date | 04/04/2019
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Last Update Date | 06/11/2025
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Provider Practice Location Address
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Address Line | 55 FRUIT ST
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City | BOSTON
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State | MA
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Zip | 02114-2621
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Country | US
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Telephone | 617-726-2553
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Fax |
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Provider Business Mailing Address
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Address Line | 61 HAVRE ST UNIT 3
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City | BOSTON
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State | MA
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Zip | 02128-3076
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Country | US
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Telephone | 508-808-3701
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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 | 2080P0206X
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Taxonomy Name | Pediatric Gastroenterology Physician
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License Number | 295012
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License Number State | MA
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