MEDICARE: NISHA DALVIE MD

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
1	208000000X	Pediatrics Physician	1014385	MA

General Provider Information

NPI Number	:	1932735057
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NISHA DALVIE MD

Provider Business Mailing Address
First Line	:	960 MASSACHUSETTS AVE STE 2
Second Line	:
City	:	BOSTON
State	:	MA
Zip	:	02118-2690
Country	:	US
Telephone Number	:	617-414-5405
Fax Number	:

Provider Business Practice Location Address
First Line	:	736 CAMBRIDGE ST FL 8
Second Line	:
City	:	BRIGHTON
State	:	MA
Zip	:	02135-2907
Country	:	US
Telephone Number	:	617-562-7077
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/20/2020
Last Update Date	:	06/09/2026

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Directions to “ NISHA DALVIE MD” Practice Location

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