Provider Demographics
NPI:1689291940
Name:KAMBANIS, PARASKEVI E (BA)
Entity Type:Individual
Prefix:
First Name:PARASKEVI
Middle Name:E
Last Name:KAMBANIS
Suffix:
Gender:F
Credentials:BA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 LONGFELLOW PL STE 201
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02114-2437
Mailing Address - Country:US
Mailing Address - Phone:617-726-8470
Mailing Address - Fax:
Practice Address - Street 1:2 LONGFELLOW PL STE 201
Practice Address - Street 2:
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02114-2437
Practice Address - Country:US
Practice Address - Phone:617-726-8470
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-07-02
Last Update Date:2020-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program