Individual
PITCHAPHON NISSAISORAKARN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
55 FRUIT ST, BOSTON, MA 02114-2696
(877) 644-2860
Mailing address
165 CAMBRIDGE ST STE 301, BOSTON, MA 02114-2751
(877) 644-2860
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
286885
MA
207RN0300X
Nephrology Physician
Primary
286885
MA
Other
Enumeration date
07/07/2015
Last updated
06/17/2021
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