Healthcare Provider Details

I. General information

NPI: 1538698006
Provider Name (Legal Business Name): NEELABH MAHESHWARI MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/08/2017
Last Update Date: 12/02/2025
Certification Date: 12/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

148 CHESTNUT ST
NEEDHAM MA
02492-2505
US

IV. Provider business mailing address

148 CHESTNUT ST
NEEDHAM MA
02492-2505
US

V. Phone/Fax

Practice location:
  • Phone: 617-754-9500
  • Fax: 617-754-9501
Mailing address:
  • Phone: 617-754-9500
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number1015415
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: