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NPI Code Detail

MEDICARE: DR. ISHA GUJRATHI MD

MEDICARE: DR. ISHA GUJRATHI MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
12085R0202XDiagnostic Radiology Physician35.156619OH
22085R0202XDiagnostic Radiology Physician1014711MA

General Provider Information

NPI Number : 1316582117
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. ISHA GUJRATHI MD
Provider Business Mailing Address
First Line : PO BOX 415348
Second Line :
City : BOSTON
State : MA
Zip : 02241-5348
Country : US
Telephone Number : 800-225-8885
Fax Number : 508-334-1977
Provider Business Practice Location Address
First Line : 55 LAKE AVE N
Second Line :
City : WORCESTER
State : MA
Zip : 01655-0002
Country : US
Telephone Number : 508-334-3850
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/15/2019
Last Update Date : 06/17/2026

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