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General NPI Number Information
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NPI Number | 1760636518
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Entity Type | Individual
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Provider Name | HOUMAN AMIRFARZAN M.D.
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Gender | Male
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Dates
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Enumeration Date | 11/06/2008
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Last Update Date | 06/11/2020
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Provider Practice Location Address
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Address Line | 1400 VFW PKWY
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City | WEST ROXBURY
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State | MA
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Zip | 02132-4927
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Country | US
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Telephone | 617-636-2000
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Fax |
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Provider Business Mailing Address
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Address Line | 59 BIRCH HILL RD
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City | BELMONT
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State | MA
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Zip | 02478-1729
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Country | US
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Telephone | 617-671-9137
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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 | 207LC0200X
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Taxonomy Name | Critical Care Medicine (Anesthesiology) Physician
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License Number | 249403
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License Number State | MA
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Taxonomy #2
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Taxonomy Code | 282N00000X
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Taxonomy Name | General Acute Care Hospital
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License Number | 232694
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License Number State | MA
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Taxonomy #3
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Taxonomy Code | 282NC0060X
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Taxonomy Name | Critical Access Hospital
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License Number | 232694
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License Number State | MA
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