Provider Demographics
NPI:1578263083
Name:PATHAK, NIDHI
Entity Type:Individual
Prefix:DR
First Name:NIDHI
Middle Name:
Last Name:PATHAK
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9 QUEEN ISABELLA WAY
Mailing Address - Street 2:
Mailing Address - City:ASHLAND
Mailing Address - State:MA
Mailing Address - Zip Code:01721-1882
Mailing Address - Country:US
Mailing Address - Phone:607-348-5925
Mailing Address - Fax:
Practice Address - Street 1:16 TEMPLE PL
Practice Address - Street 2:
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02111-1306
Practice Address - Country:US
Practice Address - Phone:617-426-2226
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-06
Last Update Date:2023-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA315237700000X
MAAUD6179231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
No237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist