Provider Demographics
NPI:1336468123
Name:LAW, ANICA C (MD)
Entity Type:Individual
Prefix:DR
First Name:ANICA
Middle Name:C
Last Name:LAW
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:960 MASSACHUSETTS AVE
Mailing Address - Street 2:FL 2
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02118-2690
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:72 E CONCORD ST # R304
Practice Address - Street 2:
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02118-2642
Practice Address - Country:US
Practice Address - Phone:617-358-1340
Practice Address - Fax:617-358-1337
Is Sole Proprietor?:No
Enumeration Date:2010-05-19
Last Update Date:2024-03-28
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MA253336207R00000X, 207RC0200X, 207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA110097486AMedicaid