| NPI Details | |
|---|---|
| NPI | 1669676284 |
| Gender | Male |
| Enumeration Date | 06/14/2007 |
| Last Updated | 07/08/2007 |
| Entity Type | Individual |
| Active | Over 10 years ago |
| Practice Location | |
|---|---|
| 25 CHURCH ST #4 WATERTOWN MA, 02472-3855, US |
|
| Phone | (617) 926-6986 |
| Fax | |
| Business Location | |
|---|---|
| 9 B ST 1ST FLOOR BELMONT MA, 02478-1903, US |
|
| Phone | (617) 484-8878 |
| Fax | |
| Toxanomy | |
|---|---|
| Taxonomy Code | 171100000X |
| License State | Massachusetts |
| License Number | 220798 |
| Remove 1669676284 NPI Number | |
According to our database, Masahiro Ichikawa NPI is 1669676284, taxonomy code is 171100000X and license number is 220798, license state is located at Massachusetts. Masahiro Ichikawa physically located at 25 Church St, Watertown MA, 02472-3855. NPI Number Masahiro Ichikawa has the Individual type.
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1669676284 NPI number is provided on an as is basis without warranty of any kind. 1669676284 is maintained by the National Plan & Provider Enumeration System. The contents of Masahiro Ichikawa are for informational purposes only.
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