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General NPI Number Information
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NPI Number | 1093275133
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Entity Type | Individual
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Provider Name | NOLAN PRIEDIGKEIT MD, PHD
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Gender | Male
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Dates
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Enumeration Date | 03/24/2019
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Last Update Date | 12/09/2024
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Provider Practice Location Address
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Address Line | 450 BROOKLINE AVE
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City | BOSTON
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State | MA
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Zip | 02215-5450
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Country | US
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Telephone | 617-632-3800
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Fax | 617-632-1930
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Provider Business Mailing Address
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Address Line | 450 BROOKLINE AVE
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City | BOSTON
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State | MA
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Zip | 02215-5450
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Country | US
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Telephone | 617-632-3800
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Fax | 617-632-1930
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RX0202X
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Taxonomy Name | Medical Oncology Physician
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License Number | 1017760
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License Number State | MA
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