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Contact Information

EDYTA M KONRAD MD, PHD
320 BOLTON ST
OFIICE # 100
MARLBOROUGH, MA01752-3988
 Phone: 508-460-6002
 Fax: 508-460-6028
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Internal Medicine

207R00000X 11 Physician/Internal Medicine
 

Nurse Practitioner

363L00000X 50 Nurse Practitioner
 

Nutrition, Education

133NN1002X
Indicates primary specialty

NPI Profile & details for EDYTA M KONRAD MD PHD · (Female)

NPI Number 1417401993
Status Active
Credentials
Entity Individual
Enumeration date 08/12/2016
Last updated 08/12/2016 - About 10 years ago
Sole proprietor 1 Not specified
Identifiers
  • MA License # 157585
  • MA Medicaid 110037908A
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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