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Soravis Osataphan
Student in an Organized Health Care Education/Training Program in Cambridge, Massachusetts
NPI 1164086518

Soravis Osataphan is a Student in an Organized Health Care Education/Training Program based in Boston, MA. Soravis Osataphan practices in Cambridge, MA. The NPI Number for Soravis Osataphan is 1164086518 and holds a License No. (Massachusetts).

The current practice location address for Soravis Osataphan is 330 Mount Auburn St, Cambridge, MA and can be reached out via phone at 617-499-5639.

Location: 330 Mount Auburn St, Cambridge, MA, 02215-5306
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1164086518
Provider Name
Soravis Osataphan
Credential
Provider Entity Type
Individual
Gender
Male
Address
330 Mount Auburn St, Cambridge, MA, 02215-5306
Phone Number
617-499-5639
Fax Number
Provider Enumeration Date
04/30/2019
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
330 Mount Auburn St
City
Cambridge
State
Massachusetts
Zip
02138-5502
Phone Number
617-499-5639
Fax Number
person
Provider Business Mailing Address Details
Address
330 Mount Auburn St
City
Cambridge
State
Massachusetts
Zip
02138-5502
Phone Number
617-499-5639
Fax Number
person
Provider's Taxonomy Details 1
Type
Student, Health Care
Classification
Student in an Organized Health Care Education/Training Program
Speciality
-
Taxonomy
390200000X
License No.
()
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
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