Provider Demographics
NPI:1720413255
Name:SWAROOP, SUJATA REGINA (PSYD)
Entity Type:Individual
Prefix:DR
First Name:SUJATA
Middle Name:REGINA
Last Name:SWAROOP
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1269 BEACON ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLINE
Mailing Address - State:MA
Mailing Address - Zip Code:02446-5248
Mailing Address - Country:US
Mailing Address - Phone:617-232-1303
Mailing Address - Fax:617-232-1280
Practice Address - Street 1:1269 BEACON ST
Practice Address - Street 2:
Practice Address - City:BROOKLINE
Practice Address - State:MA
Practice Address - Zip Code:02446-5248
Practice Address - Country:US
Practice Address - Phone:617-232-1303
Practice Address - Fax:617-232-1280
Is Sole Proprietor?:No
Enumeration Date:2013-09-03
Last Update Date:2013-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist