Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208G00000X | Cardiothoracic Vascular Surgeon | 281612 | MA |
N | 208G00000X | Cardiothoracic Vascular Surgeon | 46078 | WI |
NPI | 1083678627 |
---|---|
Provider Name | Dr. Niloo M Edwards |
First Address | Boston, MA 02119 |
Second Address | Boston, MA 02118 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/04/2006 |
Last Update Date | 26/11/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
01647098 | (05) | NY |
020028102 | RAILROAD MEDICARE (01) | NY |