IndividualActive
Amy Divasta, M.D.
NPI 1891732970 · Pediatric Adolescent Medicine Physician · Boston, MA
Provider details
- NPI number
- 1891732970
- Entity type
- Individual
- Primary specialty
- Pediatric Adolescent Medicine PhysicianAllopathic & Osteopathic Physicians
- Credential
- M.D.
- Sex
- Female
- Sole proprietor
- No
- License
- 224617 (MA)
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Practice location
300 Longwood Ave
Boston, MA 02115-5724
Phone: (617) 355-7181
Approximate (ZIP-level) locationGet directions
Mailing address
300 Longwood Ave
Boston, MA 02115-5724
Registry dates
- Enumerated
- 2006-05-31
- Last updated
- 2007-08-13
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.