Provider Demographics
NPI:1306969324
Name:SARAVANAN, YAMINI (MD)
Entity type:Individual
Prefix:
First Name:YAMINI
Middle Name:
Last Name:SARAVANAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:163 CHESTNUT HILL AVE
Mailing Address - Street 2:APT. #302
Mailing Address - City:BRIGHTON
Mailing Address - State:MA
Mailing Address - Zip Code:02135-4669
Mailing Address - Country:US
Mailing Address - Phone:617-665-1068
Mailing Address - Fax:
Practice Address - Street 1:CAMBRIDGE HOSPITAL
Practice Address - Street 2:1493 CAMBRIDGE STREET
Practice Address - City:CAMBRIDGE
Practice Address - State:MA
Practice Address - Zip Code:02139
Practice Address - Country:US
Practice Address - Phone:617-665-1068
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-06
Last Update Date:2015-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA231036207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine