Healthcare Provider Details

I. General information

NPI: 1679957559
Provider Name (Legal Business Name): NIDHI NAYYAR DPM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/10/2015
Last Update Date: 02/27/2019
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: 781-744-8650
  • Fax: 781-744-5345
Mailing address:
  • Phone: 781-744-8650
  • Fax: 781-744-5345

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213E00000X
TaxonomyPodiatrist
License Number2479
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: