Individual provider · Type 1 NPI
Tatiana Suvorov
Medical Physician Assistant · Revere, MA
NPI number
1346599420
Active
Practice location
Cha Revere Family Care Center, 454 Broadway
Revere, MA 02151
Mailing address
Cambridge Health Alliance, 1493 Cambridge Street
Cambridge, MA 02139
Other practice locations
- 600 East 233rd St, Bronx, NY 10466 · (718) 920-9177
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Medical Physician Assistant Primary | 363AM0700X | PA6778 (MA) |
| Physician Assistant | 363A00000X | 015788 (NY) |
Medical Physician Assistant: Definition to come...
Other medical physician assistant providers in Revere
About NPI 1346599420
Tatiana Suvorov's National Provider Identifier is 1346599420, issued on Sep 5, 2012. The primary taxonomy on file is Medical Physician Assistant (363AM0700X), and the practice location is in Revere, MA. The record was last updated on Jun 13, 2019.