Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | 277021 | MA |
Y | 2080P0210X | Pediatric Nephrologist | 277021 | MA |
NPI | 1629359906 |
---|---|
Provider Name | Dr. Amirtha Vahini Chinnadurai |
First Address | Boston, MA 02241-5348 |
Second Address | Worcester, MA 01655-0002 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 31/08/2011 |
Last Update Date | 19/10/2018 |