Basic Information
Provider Information
NPI: 1285875088
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: YALAMARTI
FirstName: BHARGAVI
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
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OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 620 WASHINGTON STREET
Address2:  
City: WINCHESTER
State: MA
PostalCode: 01890
CountryCode: US
TelephoneNumber: 6174923500
FaxNumber:  
Practice Location
Address1: 620 WASHINGTON STREET
Address2:  
City: WINCHESTER
State: MA
PostalCode: 01890
CountryCode: US
TelephoneNumber: 7817565000
FaxNumber:  
Other Information
ProviderEnumerationDate: 03/09/2009
LastUpdateDate: 03/30/2017
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207RH0003X246584MAY Allopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology

No ID Information.


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