Provider Demographics
NPI:1013685122
Name:FIGARO, SAMUEL (NBHWC)
Entity Type:Individual
Prefix:
First Name:SAMUEL
Middle Name:
Last Name:FIGARO
Suffix:
Gender:M
Credentials:NBHWC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:632 MASSACHUSETTS AVE APT 510
Mailing Address - Street 2:
Mailing Address - City:CAMBRIDGE
Mailing Address - State:MA
Mailing Address - Zip Code:02139-3339
Mailing Address - Country:US
Mailing Address - Phone:617-319-7073
Mailing Address - Fax:
Practice Address - Street 1:632 MASSACHUSETTS AVE APT 510
Practice Address - Street 2:
Practice Address - City:CAMBRIDGE
Practice Address - State:MA
Practice Address - Zip Code:02139-3339
Practice Address - Country:US
Practice Address - Phone:617-319-7073
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-09-02
Last Update Date:2021-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA961183994