Provider Demographics
NPI:1467893826
Name:HODARKAR, AMEYA (MD)
Entity Type:Individual
Prefix:
First Name:AMEYA
Middle Name:
Last Name:HODARKAR
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:41 MALL RD
Mailing Address - Street 2:
Mailing Address - City:BURLINGTON
Mailing Address - State:MA
Mailing Address - Zip Code:01805-4474
Mailing Address - Country:US
Mailing Address - Phone:781-744-2088
Mailing Address - Fax:401-729-3343
Practice Address - Street 1:41 MALL ROAD
Practice Address - Street 2:
Practice Address - City:BURLINGTON
Practice Address - State:MA
Practice Address - Zip Code:01805-4474
Practice Address - Country:US
Practice Address - Phone:781-744-2088
Practice Address - Fax:401-729-3343
Is Sole Proprietor?:No
Enumeration Date:2013-07-15
Last Update Date:2016-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RILP02884207R00000X
MA261279207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine