Provider Demographics
NPI:1376642157
Name:BUDMAN, SVETLANA (MD)
Entity Type:Individual
Prefix:DR
First Name:SVETLANA
Middle Name:
Last Name:BUDMAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:71 WASHINGTON ST
Mailing Address - Street 2:
Mailing Address - City:BRIGHTON
Mailing Address - State:MA
Mailing Address - Zip Code:02135-4301
Mailing Address - Country:US
Mailing Address - Phone:617-254-4966
Mailing Address - Fax:
Practice Address - Street 1:71 WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:BRIGHTON
Practice Address - State:MA
Practice Address - Zip Code:02135-4301
Practice Address - Country:US
Practice Address - Phone:617-254-4966
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-21
Last Update Date:2013-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY168171207R00000X
MA253523207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01143888Medicaid
NYE15632Medicare UPIN
NY01143888Medicaid