Individual
ANEESH K KIZHAKKEDATH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
NP
Contact information
Practice address
1 DEACONESS RD, BOSTON, MA 02215-5321
(617) 754-3180
(617) 754-3184
Mailing address
2 BANCROFT ST, WILMINGTON, MA 01887-2544
(857) 919-2364
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
266779
MA
Other
Enumeration date
05/05/2021
Last updated
08/24/2021
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