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NPI Code Detail

MEDICARE: DR. NANDINI SENGUPTA M.D.

MEDICARE: DR. NANDINI SENGUPTA M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1208000000XPediatrics Physician79130MA

General Provider Information

NPI Number : 1578513123
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. NANDINI SENGUPTA M.D.
Provider Business Mailing Address
First Line : 55 DIMOCK ST
Second Line :
City : ROXBURY
State : MA
Zip : 02119-1029
Country : US
Telephone Number : 617-442-8800
Fax Number : 617-442-5840
Provider Business Practice Location Address
First Line : 45 DIMOCK ST
Second Line :
City : ROXBURY
State : MA
Zip : 02119-1208
Country : US
Telephone Number : 617-442-8800
Fax Number : 617-442-5840
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/12/2006
Last Update Date : 01/21/2020

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