Provider Demographics
NPI:1710481981
Name:SYED, TAMKEENAT (MD)
Entity Type:Individual
Prefix:
First Name:TAMKEENAT
Middle Name:
Last Name:SYED
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 1:720 HARRISON AVE STE 915
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02118-2334
Mailing Address - Country:US
Mailing Address - Phone:617-638-8540
Mailing Address - Fax:617-638-8535
Practice Address - Street 1:720 HARRISON AVE STE 915
Practice Address - Street 2:
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02118
Practice Address - Country:US
Practice Address - Phone:617-638-8540
Practice Address - Fax:617-638-8535
Is Sole Proprietor?:No
Enumeration Date:2018-03-21
Last Update Date:2018-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
MA2763382084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program