MEDICARE: ANI TAHMASSIAN M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	229366	MA

General Provider Information

NPI Number	:	1316111313
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANI TAHMASSIAN M.D.

Provider Business Mailing Address
First Line	:	22 MILL ST STE 101
Second Line	:
City	:	ARLINGTON
State	:	MA
Zip	:	02476-4738
Country	:	US
Telephone Number	:	781-646-4345
Fax Number	:	781-646-5091

Provider Business Practice Location Address
First Line	:	22 MILL ST STE 101
Second Line	:
City	:	ARLINGTON
State	:	MA
Zip	:	02476-4738
Country	:	US
Telephone Number	:	781-646-4345
Fax Number	:	781-646-5091

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/22/2008
Last Update Date	:	02/10/2014

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