Basic Information
| Provider Information | |||||||||
| NPI: | 1508890260 | ||||||||
| EntityType: | 1 | ||||||||
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| LastName: | EHSAN | ||||||||
| FirstName: | AFSHIN | ||||||||
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| NamePrefix: | DR. | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 9 NORTHEASTERN BLVD | ||||||||
| Address2: | STE 400 | ||||||||
| City: | SALEM | ||||||||
| State: | NH | ||||||||
| PostalCode: | 030791996 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8009270002 | ||||||||
| FaxNumber: | 6038938886 | ||||||||
| Practice Location | |||||||||
| Address1: | TUFTS NEW ENGLAND MEDICAL CENTER | ||||||||
| Address2: | 750 WASHINGTON ST #266 | ||||||||
| City: | BOSTON | ||||||||
| State: | MA | ||||||||
| PostalCode: | 02111 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6176365594 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 07/10/2006 | ||||||||
| LastUpdateDate: | 08/10/2017 | ||||||||
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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 | 208G00000X | 153859 | MA | Y | Allopathic & Osteopathic Physicians | Thoracic Surgery (Cardiothoracic Vascular Surgery) |
No ID Information.