Healthcare Provider Details

I. General information

NPI: 1174731434
Provider Name (Legal Business Name): BEHZAD HEJAZIAN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/18/2007
Last Update Date: 05/02/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

LAHEY HOSPITAL AND MEDICAL CENTER 41 MALL ROAD
BURLINGTON MA
01805-0001
US

IV. Provider business mailing address

LAHEY HOSPITAL AND MEDICAL CENTER 41 MALL ROAD
BURLINGTON MA
01805-0001
US

V. Phone/Fax

Practice location:
  • Phone: 781-744-8132
  • Fax: 781-744-2273
Mailing address:
  • Phone: 781-744-8132
  • Fax: 781-744-2273

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number233758
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: