Basic Information
Provider Information
NPI: 1104980762
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: MASSAROTTI
FirstName: ELENA
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: MD
OtherOrganizationName:  
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OtherCredential:  
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Mailing Information
Address1: 375 BOYLSTON ST
Address2:  
City: BROOKLINE
State: MA
PostalCode: 024456007
CountryCode: US
TelephoneNumber: 8573070896
FaxNumber: 8573070899
Practice Location
Address1: 75 FRANCIS ST
Address2: DIVISION OF RHEUMATOLOGY
City: BOSTON
State: MA
PostalCode: 021156110
CountryCode: US
TelephoneNumber: 6177326523
FaxNumber:  
Other Information
ProviderEnumerationDate: 12/20/2006
LastUpdateDate: 10/02/2018
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
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IsSoleProprietor: N
IsOrganizationSubpart:  
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AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207RR0500X56006MAY Allopathic & Osteopathic PhysiciansInternal MedicineRheumatology

No ID Information.


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