Datta, Gouri

Datta, Gouri is an individual health care provider with primary practice located at 41 Mall Rd Lahey Clinic, Inc., Burlington MA 01805-0001. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Internal Medicine, Allopathic & Osteopathic Physicians / Psychiatry. Allopathic & Osteopathic Physicians / Psychiatry is her primary health care specialty. Datta, Gouri can be contacted via phone (781) 744-8610.

Contact Information

Primary practice address
41 Mall Rd Lahey Clinic, Inc. Burlington MA 01805-0001
Phone: (781) 744-8610
Fax: (781) 744-5235
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X 38554 Massachusetts
Allopathic & Osteopathic Physicians / Psychiatry 2084P0800X 38554 Massachusetts

Profile Details

NPI number 1528054889
LBN Legal business name Datta, Gouri
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 22nd, 2005
Last updated Apr 27th, 2017 - about 7 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1528054889 NPPES
Massachusetts MEDICAID 3037754

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