NPI 1467912808 · live from the CMS NPI Registry
Marina Avetisyan
Psychiatry & Neurology, Neurology in Boston, MA. National Provider Identifier 1467912808, active.
NPI record
| NPI | 1467912808 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Psychiatry & Neurology, Neurology 2084N0400X |
| Practice location | 55 Fruit St, Boston, MA 02114 |
| Practice phone | 617-726-2000 |
| Mailing address | 4957 Mcpherson Ave Apt D, Saint Louis, MO 63108 |
| Enumerated | March 21, 2019 |
| Last updated | July 8, 2025 |
| Sole proprietor | No |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Psychiatry & Neurology, Neurology primary | 2084N0400X | 1024439 (MA) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.