Provider Demographics
NPI:1407083280
Name:NAHAS, MYRNA RITA (MD)
Entity Type:Individual
Prefix:DR
First Name:MYRNA
Middle Name:RITA
Last Name:NAHAS
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Gender:F
Credentials:MD
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Mailing Address - Street 1:330 BROOKLINE AVE
Mailing Address - Street 2:KS 121
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02215-5400
Mailing Address - Country:US
Mailing Address - Phone:617-667-9920
Mailing Address - Fax:617-667-9922
Practice Address - Street 1:330 BROOKLINE AVE
Practice Address - Street 2:KS 121
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02215-5400
Practice Address - Country:US
Practice Address - Phone:617-667-9920
Practice Address - Fax:617-667-9922
Is Sole Proprietor?:No
Enumeration Date:2009-06-18
Last Update Date:2016-08-19
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Provider Licenses
StateLicense IDTaxonomies
MA257892207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1407083280Medicaid
CA1407083280Medicaid