Provider Demographics
NPI:1669867412
Name:THEODORE, SHEINA (MD)
Entity type:Individual
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First Name:SHEINA
Middle Name:
Last Name:THEODORE
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Gender:F
Credentials:MD
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Mailing Address - Street 1:960 MASSACHUSETTS AVENUE
Mailing Address - Street 2:FL 2
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02118-2690
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:725 ALBANY STREET
Practice Address - Street 2:SUITE 3A, SHAPIRO BUILDING
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02118
Practice Address - Country:US
Practice Address - Phone:617-414-4861
Practice Address - Fax:617-414-3617
Is Sole Proprietor?:No
Enumeration Date:2015-03-30
Last Update Date:2025-04-03
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Provider Licenses
StateLicense IDTaxonomies
MA287724208600000X, 2086S0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0102XAllopathic & Osteopathic PhysiciansSurgerySurgical Critical Care
No208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH3143532Medicaid
MA110110892AMedicaid