Basic Information
Provider Information
NPI: 1093219206
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: NZUGANG NOUTONSI
FirstName: EDWIGE CHRISTELLE
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Credential: MD
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Mailing Information
Address1: 41 MALL ROAD LAHEY HOSPITAL & MEDICAL CENTER
Address2:  
City: BURLINGTON
State: MA
PostalCode: 018050001
CountryCode: US
TelephoneNumber: 7817448085
FaxNumber: 7817445433
Practice Location
Address1: 455 TOLL GATE RD
Address2:  
City: WARWICK
State: RI
PostalCode: 02886
CountryCode: US
TelephoneNumber: 4017377010
FaxNumber: 4017361975
Other Information
ProviderEnumerationDate: 03/21/2018
LastUpdateDate: 09/07/2021
NPIDeactivationReasonCode:  
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ProviderGenderCode: F
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IsSoleProprietor: N
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NPICertificationDate: 09/07/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207R00000XLP04370RIN Allopathic & Osteopathic PhysiciansInternal Medicine 
208M00000X289791MAY Allopathic & Osteopathic PhysiciansHospitalist 

No ID Information.


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