1467499897 NPI number — CHANDER M SETHI MD

Table of content: CHANDER M SETHI MD (NPI 1467499897)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1467499897 NPI number — CHANDER M SETHI MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SETHI
Provider First Name:
CHANDER
Provider Middle Name:
M
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1467499897
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
111 CYPRESS STREET
Provider Second Line Business Mailing Address:
BWPO DBA PROVIDER ENROLLMENT
Provider Business Mailing Address City Name:
BROOKLINE
Provider Business Mailing Address State Name:
MA
Provider Business Mailing Address Postal Code:
02445
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
617-582-1253
Provider Business Mailing Address Fax Number:
617-582-1197

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
75 FRANCIS STREET
Provider Second Line Business Practice Location Address:
BRIGHAM & WOMENS HOSPITAL
Provider Business Practice Location Address City Name:
BOSTON
Provider Business Practice Location Address State Name:
MA
Provider Business Practice Location Address Postal Code:
02115
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
617-732-5500
Provider Business Practice Location Address Fax Number:
617-713-2279
Provider Enumeration Date:
06/02/2006

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207V00000X , with the licence number:  220216 , registered in the state of MA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)