Provider Demographics
NPI:1033440474
Name:KOJODJOJO, PIPIN (M,D, PHD)
Entity Type:Individual
Prefix:DR
First Name:PIPIN
Middle Name:
Last Name:KOJODJOJO
Suffix:
Gender:M
Credentials:M,D, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:660 WASHINGTON ST
Mailing Address - Street 2:APT 12T
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02111-3200
Mailing Address - Country:US
Mailing Address - Phone:617-620-3481
Mailing Address - Fax:
Practice Address - Street 1:75 FRANCIS ST
Practice Address - Street 2:
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02115-6110
Practice Address - Country:US
Practice Address - Phone:617-620-3481
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-01-25
Last Update Date:2010-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA07671191207RC0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0001XAllopathic & Osteopathic PhysiciansInternal MedicineClinical Cardiac Electrophysiology