Basic Information
| Provider Information | |||||||||
| NPI: | 1275598922 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | NAKRIN | ||||||||
| FirstName: | ANDREW | ||||||||
| MiddleName: | STEVEN | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 246 WALNUT ST | ||||||||
| Address2: | SUITE 104 - SBSC INC. | ||||||||
| City: | NEWTONVILLE | ||||||||
| State: | MA | ||||||||
| PostalCode: | 024601689 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6172443322 | ||||||||
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| Practice Location | |||||||||
| Address1: | 49 ROBINWOOD AVE | ||||||||
| Address2: | ARBOUR HOSPITAL | ||||||||
| City: | JAMAICA PLAIN | ||||||||
| State: | MA | ||||||||
| PostalCode: | 021302156 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6175224400 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 04/18/2006 | ||||||||
| LastUpdateDate: | 07/11/2011 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207L00000X | 210588 | MA | Y | Allopathic & Osteopathic Physicians | Anesthesiology |
ID Information
| ID | Type | State | Issuer | Description | 0149781 | 05 | MA | MEDICAID |