Basic Information
| Provider Information | |||||||||
| NPI: | 1154388528 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | NIGROVIC | ||||||||
| FirstName: | PETER | ||||||||
| MiddleName: | ANDRIJA | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 111 CYPRESS ST | ||||||||
| Address2: | |||||||||
| City: | BROOKLINE | ||||||||
| State: | MA | ||||||||
| PostalCode: | 024456002 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8573070896 | ||||||||
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| Practice Location | |||||||||
| Address1: | ONE JIMMY FUND WAY | ||||||||
| Address2: | RHEUMATOLOGY DIV SMITH BLDG ROOM 516C | ||||||||
| City: | BOSTON | ||||||||
| State: | MA | ||||||||
| PostalCode: | 02115 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6175251031 | ||||||||
| FaxNumber: | 6175251010 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/28/2006 | ||||||||
| LastUpdateDate: | 06/27/2012 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RR0500X | 155108 | MA | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Rheumatology | 2080P0216X | 155108 | MA | N | Allopathic & Osteopathic Physicians | Pediatrics | Pediatric Rheumatology |
No ID Information.