Divasta, Amy D

Divasta, Amy D is an individual health care provider with primary practice located at 300 Longwood Ave , Boston MA 02115-5724. She recently has only one registered license in Allopathic & Osteopathic Physicians / Adolescent Medicine, which is considered as her primary health care specialty. Divasta, Amy D can be contacted via phone (617) 355-7181.

Contact Information

Primary practice address
300 Longwood Ave Boston MA 02115-5724
Phone: (617) 355-7181
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Adolescent Medicine 2080A0000X 224617 Massachusetts

Profile Details

NPI number 1891732970
LBN Legal business name Divasta, Amy D
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 31st, 2006
Last updated Aug 13th, 2007 - about 17 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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