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General NPI Number Information
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NPI Number | 1184915803
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Entity Type | Individual
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Provider Name | JACK CLEMENT NAGGAR M.D.
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Gender | Male
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Dates
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Enumeration Date | 04/28/2011
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Last Update Date | 12/22/2023
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Provider Practice Location Address
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Address Line | 272 CENTRE ST
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City | NEWTON
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State | MA
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Zip | 02458-1618
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Country | US
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Telephone | 617-796-7170
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Fax | 617-796-7171
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Provider Business Mailing Address
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Address Line | 1 BROOKLINE PL STE 225
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City | BROOKLINE
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State | MA
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Zip | 02445-7294
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Country | US
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Telephone | 857-307-4400
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Fax | 857-307-4414
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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 | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 270115
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 262268
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License Number State | MA
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