Provider Demographics
NPI:1164164331
Name:URINA JASSIR, MANUEL ALEJANDRO (MD)
Entity Type:Individual
Prefix:
First Name:MANUEL
Middle Name:ALEJANDRO
Last Name:URINA JASSIR
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:801 MASSACHUSETTS AVE, 6TH FLOOR
Mailing Address - Street 2:CROSSTOWN PRIMARY CARE, BOSTON MEDICAL CENTER
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02119
Mailing Address - Country:US
Mailing Address - Phone:617-414-5951
Mailing Address - Fax:617-414-9251
Practice Address - Street 1:801 MASSACHUSETTS AVE, 6TH FLOOR
Practice Address - Street 2:CROSSTOWN PRIMARY CARE, BOSTON MEDICAL CENTER
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02119
Practice Address - Country:US
Practice Address - Phone:617-414-5951
Practice Address - Fax:617-414-9251
Is Sole Proprietor?:No
Enumeration Date:2022-04-08
Last Update Date:2022-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program