Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 268633 | MA |
N | 111NI0900X | Internist | 268633 | MA |
Y | 207RA0201X | Internist - Allergy & Immunology | 268633 | MA |
N | 208000000X | Pediatrician | 268633 | MA |
NPI | 1831467885 |
---|---|
Provider Name | Dr. Neelam Ameya Phadke |
First Address | Boston, MA 02114 |
Second Address | Boston, MA 02114 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 06/12/2011 |
Last Update Date | 26/03/2019 |