Provider Demographics
NPI:1326040197
Name:NARAYANASWAMI, PUSHPA (MD)
Entity Type:Individual
Prefix:
First Name:PUSHPA
Middle Name:
Last Name:NARAYANASWAMI
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:330 BROOKLINE AVENUE, ROOM 810
Mailing Address - Street 2:BIDMC NEUROLOGY SHAPIRO CLINICAL CENTER
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02215-5400
Mailing Address - Country:US
Mailing Address - Phone:617-667-4382
Mailing Address - Fax:617-667-3175
Practice Address - Street 1:330 BROOKLINE AVENUE, ROOM 810
Practice Address - Street 2:BIDMC NEUROLOGY SHAPIRO CLINICAL CENTER
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02215-5400
Practice Address - Country:US
Practice Address - Phone:617-667-4382
Practice Address - Fax:617-667-3175
Is Sole Proprietor?:No
Enumeration Date:2005-08-11
Last Update Date:2014-05-03
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Provider Licenses
StateLicense IDTaxonomies
MA2291742084N0400X, 2084N0600X, 2084N0008X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
No2084N0600XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyClinical Neurophysiology
No2084N0008XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeuromuscular Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
494968OtherTUFTS
H29857OtherHARVARD PILGRIM
J40512OtherBLUE CROSS BLUE SHIELD
MA2125234Medicaid
NA-A40098Medicare PIN
H29857OtherHARVARD PILGRIM