Provider Demographics
NPI:1194995068
Name:HAVASI, ANDREA I (MD)
Entity type:Individual
Prefix:
First Name:ANDREA
Middle Name:I
Last Name:HAVASI
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Gender:F
Credentials:MD
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Mailing Address - Street 1:801 ALBANY STREET
Mailing Address - Street 2:FL GROUND
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02119
Mailing Address - Country:US
Mailing Address - Phone:617-414-5405
Mailing Address - Fax:617-414-6031
Practice Address - Street 1:725 ALBANY STREET
Practice Address - Street 2:SHAPIRO 7, SUITE A
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02118-2526
Practice Address - Country:US
Practice Address - Phone:617-414-8601
Practice Address - Fax:617-414-8864
Is Sole Proprietor?:No
Enumeration Date:2008-03-07
Last Update Date:2020-07-13
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Provider Licenses
StateLicense IDTaxonomies
MA234857207R00000X, 207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA110082108AMedicaid
MA110082108AMedicaid