Provider Demographics
NPI:1811127327
Name:TAGHIZADEH, NAZBEH (MD)
Entity type:Individual
Prefix:
First Name:NAZBEH
Middle Name:
Last Name:TAGHIZADEH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:272 CENTRE ST
Mailing Address - Street 2:
Mailing Address - City:NEWTON
Mailing Address - State:MA
Mailing Address - Zip Code:02458-1618
Mailing Address - Country:US
Mailing Address - Phone:617-796-7100
Mailing Address - Fax:617-796-7171
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:617-796-7100
Practice Address - Fax:617-796-7171
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-17
Last Update Date:2015-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA251309207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine