Provider Demographics
NPI:1497276240
Name:AGUIRRE, LUIS E. (MD)
Entity Type:Individual
Prefix:
First Name:LUIS E.
Middle Name:
Last Name:AGUIRRE
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 1:5 FAN PIER BLVD UNIT 1103
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02210-2281
Mailing Address - Country:US
Mailing Address - Phone:617-582-9165
Mailing Address - Fax:617-632-2933
Practice Address - Street 1:450 BROOKLINE AVE # 2014D
Practice Address - Street 2:
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02215-5450
Practice Address - Country:US
Practice Address - Phone:617-582-9165
Practice Address - Fax:617-632-2933
Is Sole Proprietor?:No
Enumeration Date:2017-07-02
Last Update Date:2023-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program