Organization
ADVANCED WOUND RECOVERY - BOSTON, LLC
Active
Organization
ADVANCED WOUND RECOVERY - BOSTON, LLC
Active
Other names
Advanced Wound Recovery of Boston
Organization subpart
No
Provider details
NPI number
Authorized official
IKRAM A FAROOQI MD (MEDICAL DIRECTOR/PARTNER)
(781) 891-0030
Entity
Organization
Contact information
Practice address
9 HOPE AVE, SUITE 130, WALTHAM, MA 02453-2741
(781) 891-0030
(781) 891-7030
Mailing address
9 HOPE AVE, SUITE 130, WALTHAM, MA 02453-2741
(781) 891-0030
(781) 891-7030
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3600202
AETNA
MA
01
—
696163
TUFTS
MA
05
—
9736221
—
MA
01
—
M18836
BCBS
MA
Enumeration date
08/10/2006
Last updated
08/22/2020
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