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Organization
JOHN L. NILES MD, PLLC
Active
Organization
JOHN L. NILES MD, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOHN L NILES M.D. (OWNER)
(617) 726-4132
Entity
Organization
Contact information
Practice address
101 MERRIMAC ST, 1ST FLOOR, BOSTON, MA 02114-4724
(617) 726-4132
(617) 726-4213
Mailing address
101 MERRIMAC ST, 1ST FLOOR, BOSTON, MA 02114-4724
(617) 726-4132
(617) 726-4213
Taxonomy
Speciality
Code
Description
License number
State
261QM2500X
Medical Specialty Clinic/Center
Primary
54243
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
AA399963
HPHC
MA
Enumeration date
09/19/2013
Last updated
02/04/2015
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