Provider Demographics
NPI:1184915803
Name:NAGGAR, JACK CLEMENT (MD)
Entity type:Individual
Prefix:
First Name:JACK
Middle Name:CLEMENT
Last Name:NAGGAR
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:1 BROOKLINE PL STE 225
Mailing Address - Street 2:
Mailing Address - City:BROOKLINE
Mailing Address - State:MA
Mailing Address - Zip Code:02445-7294
Mailing Address - Country:US
Mailing Address - Phone:857-307-4400
Mailing Address - Fax:857-307-4414
Practice Address - Street 1:272 CENTRE ST
Practice Address - Street 2:
Practice Address - City:NEWTON
Practice Address - State:MA
Practice Address - Zip Code:02458-1618
Practice Address - Country:US
Practice Address - Phone:617-796-7170
Practice Address - Fax:617-796-7171
Is Sole Proprietor?:No
Enumeration Date:2011-04-28
Last Update Date:2023-12-22
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY270115207R00000X
MA262268207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine