Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 269402 | MA |
N | 111NI0900X | Internist | 269402 | MA |
Y | 207RE0101X | Endocrinologist (Diabetes Doctor) | 269402 | MA |
NPI | 1023551165 |
---|---|
Provider Name | Shahd Bsata |
First Address | Boston, MA 02118-2371 |
Second Address | Boston, MA 02118-2371 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 21/11/2016 |
Last Update Date | 24/08/2020 |