Provider Demographics
NPI:1255751657
Name:FRAIMAN, YARDEN S
Entity type:Individual
Prefix:MR
First Name:YARDEN
Middle Name:S
Last Name:FRAIMAN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 LONGWOOD AVE, BOSTON CHILDREN'S HOSPITAL,
Mailing Address - Street 2:HUNNEWELL BUILDING, PAVILION 129, HOUSESTAFF LOUNGE
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02115
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:300 LONGWOOD AVE, BOSTON CHILDREN'S HOSPITAL
Practice Address - Street 2:HUNNEWELL BUILDING, PAVILION 129, HOUSESTAFF LOUNGE
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02115
Practice Address - Country:US
Practice Address - Phone:617-355-5000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-04-24
Last Update Date:2021-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA274256208000000X, 2080N0001X
ILF65597787083390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080N0001XAllopathic & Osteopathic PhysiciansPediatricsNeonatal-Perinatal Medicine
No208000000XAllopathic & Osteopathic PhysiciansPediatrics
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program