Individual
MANUCHER FARDI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
105 ERDMAN WAY, LEOMINSTER, MA 01453-1805
(978) 466-7800
(978) 466-9333
Mailing address
58 EDGELAWN AVE, UNIT #12, NORTH ANDOVER, MA 01845-4479
(978) 944-0981
(978) 466-9333
Taxonomy
Speciality
Code
Description
License number
State
207ZP0101X
Anatomic Pathology Physician
Primary
78320
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
078320
TUFTS
MA
05
—
3159531
—
MA
01
—
AA8479
HPHC
MA
01
—
J17221
BCBS
MA
Enumeration date
10/18/2005
Last updated
12/23/2015
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