Individual
PETER NIELSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
41 MALL RD, BURLINGTON, MA 01805-0002
(781) 744-2920
Mailing address
PROVIDER ENROLLMENT 41 MALL ROAD, BURLINGTON, MA 01805-0001
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
1022092
MA
207L00000X
Anesthesiology Physician
23796
NV
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/29/2019
Last updated
04/21/2025
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