Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Y00000X | Otolaryngologist (ENT Doctor) | 223730 | MA |
NPI | 1083602163 |
---|---|
Provider Name | Vijay K Nayak |
First Address | Chelmsford, MA 01824-2738 |
Second Address | Chelmsford, MA 01824-2738 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/10/2005 |
Last Update Date | 16/04/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
2101467 | (05) | MA |
A38480 | (02) | |
J28615 | BCBS (01) | MA |