Organization Name: | PARESH K THAKKAR MD LLC |
NPI Number: | 1255501136 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | PARESH K THAKKAR (PRESIDENT) |
Mailing Address: | 13 Wabanaki Way Andover |
State: | MA US |
Postal Code: | 018105524 |
Phone Number: | 9784703592 |
Fax Number: | 9784703592 |
NPI Enumeration Date: | 03/06/2008 |
NPI Last Update Date: | 03/06/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | 53603 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MA |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |