Nishiyama, Stephen Takeo
Nishiyama, Stephen Takeo is an individual health care provider with primary practice located at 40 Second Ave Ste 400, Waltham MA 02451. He recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as his primary health care specialty. Nishiyama, Stephen Takeo can be contacted via phone (781) 487-4340.Contact Information
Primary practice address
40 Second Ave Ste 400
Waltham MA 02451
Phone: (781) 487-4340
Fax: (781) 487-4341
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Pediatrics | 208000000X | 81412 | Massachusetts |
Profile Details
| NPI number | 1710978622 |
|---|---|
| LBN Legal business name | Nishiyama, Stephen Takeo |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Oct 31st, 2005 |
| Last updated | Jan 3rd, 2013 - about 12 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1710978622 | NPPES |
| Massachusetts | Other | 081412 | TUFTS HEALTH PLAN |
| Massachusetts | Other | J31669 | TUFTS HEALTH PLAN |
| Massachusetts | MEDICAID | 3141683 | TUFTS HEALTH PLAN |
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