Provider Demographics
NPI:1982648234
Name:SRETER, ESTHER E (MD)
Entity Type:Individual
Prefix:
First Name:ESTHER
Middle Name:E
Last Name:SRETER
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 1:10 STEELE ST
Mailing Address - Street 2:
Mailing Address - City:STONEHAM
Mailing Address - State:MA
Mailing Address - Zip Code:02180-4148
Mailing Address - Country:US
Mailing Address - Phone:781-979-3120
Mailing Address - Fax:781-979-3994
Practice Address - Street 1:585 LEBANON ST
Practice Address - Street 2:RADIOLOGY DEPARTMENT
Practice Address - City:MELROSE
Practice Address - State:MA
Practice Address - Zip Code:02176-3225
Practice Address - Country:US
Practice Address - Phone:781-979-3120
Practice Address - Fax:781-979-3994
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA0553772085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA3086062Medicaid
MAJ11956Medicare ID - Type Unspecified
MA3086062Medicaid