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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

NPI Number 1417401993
LBN Legal business name EDYTA M KONRAD MD, PHD
Authorized official EDYTA KONRAD - (OWNER)
Entity Organization
Organization subpart 1 No
Enumeration date 08/12/2016
Last updated 08/12/2016 - About 10 years ago
Identifiers
MA License # 157585
MA Medicaid 110037908A
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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