Provider Demographics
NPI:1255388047
Name:AMIRI, TORYALAI (MD)
Entity type:Individual
Prefix:
First Name:TORYALAI
Middle Name:
Last Name:AMIRI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:37 PINE PLAIN RD
Mailing Address - Street 2:
Mailing Address - City:BOXFORD
Mailing Address - State:MA
Mailing Address - Zip Code:01921-1243
Mailing Address - Country:US
Mailing Address - Phone:781-592-3183
Mailing Address - Fax:
Practice Address - Street 1:225 BOSTON ST
Practice Address - Street 2:SUITE 306
Practice Address - City:LYNN
Practice Address - State:MA
Practice Address - Zip Code:01904-3137
Practice Address - Country:US
Practice Address - Phone:781-592-3183
Practice Address - Fax:781-592-3356
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-27
Last Update Date:2010-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA59446207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAE17053Medicare UPIN