Individual
NIMA OMID-FARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
55 FRUIT STREET, GRAY 2 ROOM 241 G, BOSTON, MA 02114
(617) 726-8320
(617) 724-3338
Mailing address
55 FRUIT STREET, GRAY 2 ROOM 241 G, BOSTON, MA 02114
(617) 726-8320
(617) 724-3338
Taxonomy
Speciality
Code
Description
License number
State
2085D0003X
Diagnostic Neuroimaging (Radiology) Physician
1018223
MA
2085N0700X
Neuroradiology Physician
1018223
MA
2085R0202X
Diagnostic Radiology Physician
Primary
1018223
MA
Other
Enumeration date
05/28/2024
Last updated
08/20/2024
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