Basic Information
| Provider Information | |||||||||
| NPI: | 1720582901 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | SUBEDI | ||||||||
| FirstName: | KRIPESH | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 801 ALBANY STREET FL GROUND | ||||||||
| Address2: | |||||||||
| City: | BOSTON | ||||||||
| State: | MA | ||||||||
| PostalCode: | 02119 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6174147399 | ||||||||
| FaxNumber: | 6176383536 | ||||||||
| Practice Location | |||||||||
| Address1: | 801 MASSACHUSETTS AVENUE, CROSSTOWN 2 | ||||||||
| Address2: | |||||||||
| City: | BOSTON | ||||||||
| State: | MA | ||||||||
| PostalCode: | 02118 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6174147399 | ||||||||
| FaxNumber: | 6176383536 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/21/2018 | ||||||||
| LastUpdateDate: | 10/07/2021 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 10/07/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | 290037 | MA | Y | Allopathic & Osteopathic Physicians | Internal Medicine |
No ID Information.