Provider Demographics
NPI:1376093260
Name:AJAY ANAND MD PC
Entity Type:Organization
Organization Name:AJAY ANAND MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EMPLOYER
Authorized Official - Prefix:
Authorized Official - First Name:ANAND
Authorized Official - Middle Name:
Authorized Official - Last Name:AJAY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:781-642-1912
Mailing Address - Street 1:3 WESTSIDE DR
Mailing Address - Street 2:
Mailing Address - City:ACTON
Mailing Address - State:MA
Mailing Address - Zip Code:01720-5939
Mailing Address - Country:US
Mailing Address - Phone:978-897-5127
Mailing Address - Fax:
Practice Address - Street 1:29 DEER PATH LN
Practice Address - Street 2:
Practice Address - City:WESTON
Practice Address - State:MA
Practice Address - Zip Code:02493-1139
Practice Address - Country:US
Practice Address - Phone:781-642-1912
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-10-04
Last Update Date:2016-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN263919313M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes313M00000XNursing & Custodial Care FacilitiesNursing Facility/Intermediate Care Facility