Basic Information
| Provider Information | |||||||||
| NPI: | 1124393343 | ||||||||
| EntityType: | 1 | ||||||||
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| LastName: | JIRAPINYO | ||||||||
| FirstName: | PICHAMOL | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 375 BOYLSTON ST | ||||||||
| Address2: | |||||||||
| City: | BROOKLINE | ||||||||
| State: | MA | ||||||||
| PostalCode: | 024456007 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8573070896 | ||||||||
| FaxNumber: | 8573070899 | ||||||||
| Practice Location | |||||||||
| Address1: | 20 YORK ST # T-209 | ||||||||
| Address2: | YALE-NEW HAVEN HOSPITAL | ||||||||
| City: | NEW HAVEN | ||||||||
| State: | CT | ||||||||
| PostalCode: | 065103220 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2036882259 | ||||||||
| FaxNumber: | 2036885599 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/21/2012 | ||||||||
| LastUpdateDate: | 07/17/2019 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RG0100X | 266882 | MA | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Gastroenterology | 390200000X | N | Student, Health Care | Student in an Organized Health Care Education/Training Program |
No ID Information.