Healthcare Provider Details
I. General information
NPI: 1447255336
Provider Name (Legal Business Name): ABENDRA B. NAIDOO MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 06/16/2005
Last Update Date: 03/07/2023
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
48 EAST SILVER STREET SUITE 4
WESTFIELD MA
01085
US
IV. Provider business mailing address
218 N PEARMAN AVE
CLEVELAND MS
38732-2634
US
V. Phone/Fax
- Phone: 413-562-8088
- Fax: 413-562-8006
- Phone: 662-846-1112
- Fax: 662-846-1170
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207RC0000X |
| Taxonomy | Cardiovascular Disease Physician |
| License Number | ME99335 |
| License Number State | FL |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207RC0001X |
| Taxonomy | Clinical Cardiac Electrophysiology Physician |
| License Number | ME99335 |
| License Number State | FL |
| # 3 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207RC0000X |
| Taxonomy | Cardiovascular Disease Physician |
| License Number | 56295 |
| License Number State | MA |
| # 4 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207RC0001X |
| Taxonomy | Clinical Cardiac Electrophysiology Physician |
| License Number | 56295 |
| License Number State | MA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: