Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RN0300X | Nephrologist | 155328 | MA |
NPI | 1043299944 |
---|---|
Provider Name | Ian R. Rifkin |
First Address | Boston, MA 02118 |
Second Address | Boston, MA 02118-2526 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/01/2006 |
Last Update Date | 22/05/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0109771 | (05) | MA |
H26036 | (02) | MA |