Provider Demographics
NPI:1568632438
Name:GHOSHHAJRA, MONICA G (MD)
Entity Type:Individual
Prefix:
First Name:MONICA
Middle Name:G
Last Name:GHOSHHAJRA
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:LAHEY HOSPITAL AND MEDICAL CENTER
Mailing Address - Street 2:41 MALL ROAD
Mailing Address - City:BURLINGTON
Mailing Address - State:MA
Mailing Address - Zip Code:01805-0001
Mailing Address - Country:US
Mailing Address - Phone:781-744-8442
Mailing Address - Fax:781-744-3442
Practice Address - Street 1:LAHEY HOSPITAL AND MEDICAL CENTER
Practice Address - Street 2:41 MALL ROAD
Practice Address - City:BURLINGTON
Practice Address - State:MA
Practice Address - Zip Code:01805-0001
Practice Address - Country:US
Practice Address - Phone:781-744-8442
Practice Address - Fax:781-744-3442
Is Sole Proprietor?:No
Enumeration Date:2008-03-07
Last Update Date:2019-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA235122207K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & Immunology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AA122702OtherHARVARD PILGRIM
MA11079758AMedicaid
MA000599401Medicare UPIN