Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RC0200X | Critical Care Medicine | 268472 | MA |
Y | 207RP1001X | Pulmonary Disease | 268472 | MA |
NPI | 1093151656 |
---|---|
Provider Name | Anish Geevarghese |
First Address | West Bridgewater, MA 02379-1056 |
Second Address | Methuen, MA 01844-4597 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 22/05/2013 |
Last Update Date | 20/08/2019 |