Provider Demographics
NPI:1598758195
Name:NIRMEL, KRISHNA NARANDAS (MD, FACS)
Entity Type:Individual
Prefix:DR
First Name:KRISHNA
Middle Name:NARANDAS
Last Name:NIRMEL
Suffix:
Gender:M
Credentials:MD, FACS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 UNION ST
Mailing Address - Street 2:3RD FLOOR
Mailing Address - City:NATICK
Mailing Address - State:MA
Mailing Address - Zip Code:01760-4759
Mailing Address - Country:US
Mailing Address - Phone:508-650-1022
Mailing Address - Fax:508-653-7420
Practice Address - Street 1:10 UNION ST
Practice Address - Street 2:3RD FLOOR
Practice Address - City:NATICK
Practice Address - State:MA
Practice Address - Zip Code:01760-4759
Practice Address - Country:US
Practice Address - Phone:508-650-1022
Practice Address - Fax:508-653-7420
Is Sole Proprietor?:No
Enumeration Date:2005-08-30
Last Update Date:2011-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA50220174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAE05941OtherBLUE CROSS BLUE SHIELD
MA050220OtherTUFTS PROVIDER NUMBER
MA12052OtherHARVARD PILGRIM PROV #
MA0181579Medicaid
MA050220OtherTUFTS PROVIDER NUMBER
MAA54980Medicare UPIN