Basic Information
| Provider Information | |||||||||
| NPI: | 1588608533 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SEETHARAMAN | ||||||||
| FirstName: | KAVITA | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1 JOSLIN PL | ||||||||
| Address2: | |||||||||
| City: | BOSTON | ||||||||
| State: | MA | ||||||||
| PostalCode: | 022155306 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6173092400 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1 JOSLIN PL | ||||||||
| Address2: | |||||||||
| City: | BOSTON | ||||||||
| State: | MA | ||||||||
| PostalCode: | 022155306 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6173092400 | ||||||||
| FaxNumber: | 7744424668 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/16/2006 | ||||||||
| LastUpdateDate: | 02/01/2018 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | 220006 | MA | N | Allopathic & Osteopathic Physicians | Internal Medicine | 207RE0101X | 220006 | MA | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Endocrinology, Diabetes & Metabolism |
ID Information
| ID | Type | State | Issuer | Description | AA18113 | 01 | MA | HARVARD PILGRIM | OTHER | 2084741 | 05 | MA | MEDICAID | 469713 | 01 | MA | TUFTS | OTHER | 0033565 | 01 | MA | NEIGHBORHOOD HEALTH | OTHER | J28067 | 01 | MA | BLUE CROSS | OTHER |