Provider Demographics
NPI:1356918437
Name:MASSOUDI, NATASHA (MD, MPH)
Entity type:Individual
Prefix:
First Name:NATASHA
Middle Name:
Last Name:MASSOUDI
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Gender:F
Credentials:MD, MPH
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Other - Credentials:
Mailing Address - Street 1:15 LA SALLE SQ
Mailing Address - Street 2:
Mailing Address - City:PROVIDENCE
Mailing Address - State:RI
Mailing Address - Zip Code:02903-1814
Mailing Address - Country:US
Mailing Address - Phone:401-444-6779
Mailing Address - Fax:401-444-6912
Practice Address - Street 1:164 SUMMIT AVE STE 2B
Practice Address - Street 2:
Practice Address - City:PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02906-2853
Practice Address - Country:US
Practice Address - Phone:401-793-4300
Practice Address - Fax:401-793-4312
Is Sole Proprietor?:No
Enumeration Date:2021-06-08
Last Update Date:2025-11-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
RIMD206962084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry