Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Y00000X | Otolaryngologist (ENT Doctor) | 252372 | MA |
NPI | 1073869616 |
---|---|
Provider Name | Dr. Niranjan Sritharan |
First Address | Brookline, MA 02446-3552 |
Second Address | Brighton, MA 02135-2907 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/08/2012 |
Last Update Date | 01/08/2012 |