Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 270874 | MA |
N | 111NI0900X | Internist | 270874 | MA |
N | 207R00000X | Internist | MT205806 | PA |
N | 111NI0900X | Internist | MT205806 | PA |
N | 207RA0001X | Advanced Heart Failure and Transplant Cardiologist | 21365 | NH |
Y | 207RA0001X | Advanced Heart Failure and Transplant Cardiologist | 270874 | MA |
N | 207RC0000X | Internist - Cardiovascular Disease | 21365 | NH |
N | 207RC0000X | Internist - Cardiovascular Disease | 270874 | MA |
NPI | 1205256609 |
---|---|
Provider Name | Nilay Sutaria |
First Address | Boston, MA 02114-2621 |
Second Address | Boston, MA 02114-2621 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/04/2014 |
Last Update Date | 17/08/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
3127528 | (05) | NH |