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General NPI Number Information
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NPI Number | 1154392108
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Entity Type | Individual
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Provider Name | ASHOK N. NIMGADE MD, MPH, MS, SM
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Gender | Male
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Dates
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Enumeration Date | 01/29/2006
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Last Update Date | 10/04/2011
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Provider Practice Location Address
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Address Line | 101 SUMMIT AVE
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City | BROOKLINE
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State | MA
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Zip | 02446-2305
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Country | US
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Telephone | 617-875-2946
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Fax |
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Provider Business Mailing Address
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Address Line | 101 SUMMIT AVE
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City | BROOKLINE
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State | MA
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Zip | 02446-2305
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Country | US
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Telephone | 617-875-2946
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Fax |
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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 | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number | 154378
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License Number State | MA
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