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General NPI Number Information
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NPI Number | 1205991551
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Entity Type | Individual
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Provider Name | PRIYA SHANKAR NANDI MD
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Gender | Male
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Dates
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Enumeration Date | 12/27/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 2 ADAMS PLACE SUITE 405
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City | QUINCY
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State | MA
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Zip | 02169-7456
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Country | US
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Telephone | 781-939-3500
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Fax | 981-939-3570
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Provider Business Mailing Address
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Address Line | 100 BLUEBERRY LANE
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City | WESTWOOD
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State | MA
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Zip | 02090
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Country | US
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Telephone | 781-769-7575
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Fax | 781-769-7535
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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 | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | 35191
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License Number State | MA
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