Doctor Name: | JASMINE V VARTIKAR |
NPI Number: | 1275777617 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | M.D. |
License Number: | 57662 |
Business Practice Address: | 637 Washington St Suite 103 Brookline, MA - 024464500 |
Business Phone Number: | 6172771614 |
Business Fax Number: | |
Mailing Address: | 94 Babcock St, BROOKLINE |
State: | MA |
Postal Code: | 024465900 |
Phone Number: | 6172771614 |
Fax Number: | |
NPI Enumeration Date: | 04/29/2009 |
NPI Last Update Date: | 04/29/2009 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | 57662 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MA |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |