Basic Information
Provider Information
NPI: 1053738344
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: HOOD PISHCHANY
FirstName: MARGUERITE
MiddleName: INDRIATI
NamePrefix: DR.
NameSuffix:  
Credential: MD, PHD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName: HOOD
OtherFirstName: MARGUERITE
OtherMiddleName: INDRIATI
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType: 2
Mailing Information
Address1: 300 LONGWOOD AVE
Address2:  
City: BOSTON
State: MA
PostalCode: 021155724
CountryCode: US
TelephoneNumber: 6173556363
FaxNumber:  
Practice Location
Address1: 300 LONGWOOD AVE
Address2:  
City: BOSTON
State: MA
PostalCode: 021155724
CountryCode: US
TelephoneNumber: 6173556363
FaxNumber:  
Other Information
ProviderEnumerationDate: 03/25/2014
LastUpdateDate: 12/14/2019
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 12/14/2019

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
208000000X270621MAN Allopathic & Osteopathic PhysiciansPediatrics 
2080P0208X270621MAY Allopathic & Osteopathic PhysiciansPediatricsPediatric Infectious Diseases

No ID Information.


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