Provider Demographics
NPI:1275598922
Name:NAKRIN, ANDREW STEVEN (MD)
Entity Type:Individual
Prefix:
First Name:ANDREW
Middle Name:STEVEN
Last Name:NAKRIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:246 WALNUT ST
Mailing Address - Street 2:SUITE 104 - SBSC INC.
Mailing Address - City:NEWTONVILLE
Mailing Address - State:MA
Mailing Address - Zip Code:02460-1689
Mailing Address - Country:US
Mailing Address - Phone:617-244-3322
Mailing Address - Fax:
Practice Address - Street 1:49 ROBINWOOD AVE
Practice Address - Street 2:ARBOUR HOSPITAL
Practice Address - City:JAMAICA PLAIN
Practice Address - State:MA
Practice Address - Zip Code:02130-2156
Practice Address - Country:US
Practice Address - Phone:617-522-4400
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-18
Last Update Date:2011-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA210588207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA0149781Medicaid
MAA33104Medicare ID - Type Unspecified
MA0149781Medicaid