Provider Demographics
NPI:1235113010
Name:POTTER, MONA PATEL (MD)
Entity Type:Individual
Prefix:DR
First Name:MONA
Middle Name:PATEL
Last Name:POTTER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:MONA
Other - Middle Name:PARSOTTAM
Other - Last Name:PATEL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:5 LOCKE LANE
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:MA
Mailing Address - Zip Code:02420
Mailing Address - Country:US
Mailing Address - Phone:615-424-3398
Mailing Address - Fax:617-928-8649
Practice Address - Street 1:396 WASHINGTON ST # 266
Practice Address - Street 2:
Practice Address - City:WELLESLEY HILLS
Practice Address - State:MA
Practice Address - Zip Code:02481-6209
Practice Address - Country:US
Practice Address - Phone:855-438-8331
Practice Address - Fax:617-928-8649
Is Sole Proprietor?:Yes
Enumeration Date:2005-12-05
Last Update Date:2022-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2239702084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry