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Provider Information for 1356310270

Please Note: Issuance of an NPI does not ensure or validate that the Health Care Provider is Licensed or Credentialed. For more information please refer to NPI: What You Need to Know

PANKAJ B. AGRAWAL MD

Gender: MALE

Individual NPI: 1356310270

Calendar   Last Updated:  2016-10-10
  Certification Date: 

Details

Name Value
NPI 1356310270
Enumeration Date 2006-03-14
NPI Type 1 - Individual
Sole Proprietor NO
Status Active
Mailing Address 11 MYERSON LN
NEWTON, MA 02459-3508
United States

Phone: 617-721-2262 | Fax: 617-730-0253
View Map External Link
Primary Practice Address 300 LONGWOOD AVE
BOSTON, MA 02115-5724
United States

Phone: 617-919-2153 | Fax: 617-730-0253
View Map External Link
Health Information Exchange
Endpoint Type Endpoint Endpoint Description Use Content Type Affiliation Endpoint Location
Other Identifiers
Issuer State Number
Taxonomy
Primary Taxonomy Selected Taxonomy State License Number
Yes 2080N0001X - Pediatrics Neonatal-Perinatal Medicine MA 212901