Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207V00000X | Obstetrician & Gynecologist | 226195 | MA |
NPI | 1003887456 |
---|---|
Provider Name | Dr. Sutapa Ghosh |
First Address | East Boston, MA 02128-1920 |
Second Address | East Boston, MA 02128-1920 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 01/02/2006 |
Last Update Date | 24/10/2018 |