MEDICARE: ZACHARY L. TATARYN 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
1	207T00000X	Neurological Surgery Physician	MD61125187	WA
2	207T00000X	Neurological Surgery Physician	295007	MA

General Provider Information

NPI Number	:	1518251834
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ZACHARY L. TATARYN MD

Provider Business Mailing Address
First Line	:	960 MASSACHUSETTS AVE
Second Line	:	FL 2
City	:	BOSTON
State	:	MA
Zip	:	02118-2690
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	736 CAMBRIDGE ST FL 6
Second Line	:
City	:	BRIGHTON
State	:	MA
Zip	:	02135-2907
Country	:	US
Telephone Number	:	617-779-6083
Fax Number	:	617-415-2002

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/03/2011
Last Update Date	:	03/09/2026

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