Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213ES0131X | Foot Surgery | 1740318773 | NY |
NPI | 1043746878 |
---|---|
Provider Name | Faezeh Bakhtiari-Nejad |
First Address | Cambridge, MA 02140-2443 |
Second Address | Cambridge, MA 02140-2338 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/05/2017 |
Last Update Date | 11/05/2017 |