MEDICARE: DR. SVETLANA KONDRATIEV 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	207ZP0102X	Anatomic Pathology & Clinical Pathology Physician	MD13650	RI
2	207ZP0102X	Anatomic Pathology & Clinical Pathology Physician	229270	MA

General Provider Information

NPI Number	:	1780852624
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SVETLANA KONDRATIEV MD

Provider Business Mailing Address
First Line	:	67 SLADES FERRY AVE STE 6720
Second Line	:
City	:	SOMERSET
State	:	MA
Zip	:	02726-1220
Country	:	US
Telephone Number	:	401-921-0252
Fax Number	:

Provider Business Practice Location Address
First Line	:	75 FRANCIS ST
Second Line	:
City	:	BOSTON
State	:	MA
Zip	:	02115-6110
Country	:	US
Telephone Number	:	617-732-5500
Fax Number	:

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

Provider Enumeration Date	:	02/13/2008
Last Update Date	:	05/05/2026

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