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General NPI Number Information
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NPI Number | 1396083051
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Entity Type | Organization
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Legal Business Name | BOSTON WEST CARDIOLOGY
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Dates
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Enumeration Date | 01/30/2013
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Last Update Date | 01/30/2013
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Provider Practice Location Address
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Address Line | 20 HOPE AVE STE G07
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City | WALTHAM
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State | MA
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Zip | 02453-2717
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Country | US
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Telephone | 781-894-1199
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Fax | 781-657-6178
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Provider Business Mailing Address
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Address Line | 20 HOPE AVE STE G07
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City | WALTHAM
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State | MA
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Zip | 02453-2717
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Country | US
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Telephone | 781-894-1199
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Fax | 781-657-6178
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Authorized Official
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Title or Position | PRESIDENT
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Name | RIFAT DWEIK
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Credential | MD
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Telephone | 781-894-1199
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | 58014
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License Number State | MA
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