Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 233056 | MA |
N | 111NI0900X | Internist | 233056 | MA |
Y | 207RN0300X | Nephrologist | 233056 | MA |
NPI | 1063602100 |
---|---|
Provider Name | Dr. Manish R Maski |
First Address | Boston, MA 02109-4806 |
Second Address | Boston, MA 02215-3904 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/07/2007 |
Last Update Date | 25/10/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
110089044A | (05) | MA |