Healthcare Provider Details

I. General information

NPI: 1730348111
Provider Name (Legal Business Name): MARCIN ANDRZEJ TROJANOWSKI MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/02/2008
Last Update Date: 10/05/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

725 ALBANY ST SHAPIRO 7 SUITE B
BOSTON MA
02118-2526
US

IV. Provider business mailing address

720 HARRISON AVE DOB 503
BOSTON MA
02118-2371
US

V. Phone/Fax

Practice location:
  • Phone: 617-638-1460
  • Fax: 617-638-5226
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RR0500X
TaxonomyRheumatology Physician
License Number268421
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: