Provider Demographics
NPI:1215119003
Name:MATTAPAN MEDICAL ASSOCIATES INC
Entity type:Organization
Organization Name:MATTAPAN MEDICAL ASSOCIATES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD
Authorized Official - Prefix:DR
Authorized Official - First Name:NASIR
Authorized Official - Middle Name:ALAM
Authorized Official - Last Name:BHATTI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:617-296-3500
Mailing Address - Street 1:1537 BLUE HILL AVE
Mailing Address - Street 2:
Mailing Address - City:MATTAPAN
Mailing Address - State:MA
Mailing Address - Zip Code:02126-2103
Mailing Address - Country:US
Mailing Address - Phone:617-296-3500
Mailing Address - Fax:617-296-5608
Practice Address - Street 1:1537 BLUE HILL AVE
Practice Address - Street 2:
Practice Address - City:MATTAPAN
Practice Address - State:MA
Practice Address - Zip Code:02126-2103
Practice Address - Country:US
Practice Address - Phone:617-296-3500
Practice Address - Fax:617-296-5608
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-04
Last Update Date:2007-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty