Provider Demographics
NPI:1013903673
Name:LIANGOS, ORFEAS (MD)
Entity Type:Individual
Prefix:
First Name:ORFEAS
Middle Name:
Last Name:LIANGOS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:736 CAMBRIDGE ST
Mailing Address - Street 2:CBR 404
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02135-2907
Mailing Address - Country:US
Mailing Address - Phone:617-562-7654
Mailing Address - Fax:617-779-6064
Practice Address - Street 1:736 CAMBRIDGE ST
Practice Address - Street 2:ST ELIZABETHS MED CTR
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02135-2907
Practice Address - Country:US
Practice Address - Phone:617-789-3100
Practice Address - Fax:617-789-2467
Is Sole Proprietor?:No
Enumeration Date:2005-09-20
Last Update Date:2009-02-25
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MA208670207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA2152188Medicaid
I32938Medicare UPIN
MA2152188Medicaid