Provider Demographics
NPI:1245298637
Name:ROY, ASHOK K (MD)
Entity type:Individual
Prefix:
First Name:ASHOK
Middle Name:K
Last Name:ROY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:9 HANSON ST
Mailing Address - Street 2:#3
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02118-3626
Mailing Address - Country:US
Mailing Address - Phone:617-253-4481
Mailing Address - Fax:
Practice Address - Street 1:77 MASS AVE BLDG E23
Practice Address - Street 2:MIT MEDICAL CENTER
Practice Address - City:CAMBRIDGE
Practice Address - State:MA
Practice Address - Zip Code:02139
Practice Address - Country:US
Practice Address - Phone:617-253-4481
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-03
Last Update Date:2014-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA224638207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine