Provider Demographics
NPI:1346805595
Name:BOUNNI, FIRAS (MD)
Entity Type:Individual
Prefix:
First Name:FIRAS
Middle Name:
Last Name:BOUNNI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Mailing Address - Street 1:260 TREMONT ST
Mailing Address - Street 2:DEPT OF NEUROLOGY
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02116-5603
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:562-491-9146
Practice Address - Street 1:260 TREMONT ST
Practice Address - Street 2:DEPT OF NEUROLOGY
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02116-5603
Practice Address - Country:US
Practice Address - Phone:617-636-5000
Practice Address - Fax:562-491-9146
Is Sole Proprietor?:Yes
Enumeration Date:2019-05-03
Last Update Date:2021-07-24
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CA3115207R00000X
MAT2897002084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine