Provider Demographics
NPI:1366540361
Name:DANA, NAVA (MD)
Entity type:Individual
Prefix:
First Name:NAVA
Middle Name:
Last Name:DANA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:41 MALL RD
Mailing Address - Street 2:
Mailing Address - City:BURLINGTON
Mailing Address - State:MA
Mailing Address - Zip Code:01805-0001
Mailing Address - Country:US
Mailing Address - Phone:781-744-8000
Mailing Address - Fax:781-744-5352
Practice Address - Street 1:67 S BEDFORD ST STE 202E
Practice Address - Street 2:
Practice Address - City:BURLINGTON
Practice Address - State:MA
Practice Address - Zip Code:01803-5141
Practice Address - Country:US
Practice Address - Phone:781-744-7000
Practice Address - Fax:781-744-5352
Is Sole Proprietor?:No
Enumeration Date:2006-09-21
Last Update Date:2021-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA46953207RN0300X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA110056566AMedicaid
MA3146367Medicaid
MAG095592Medicare UPIN
MA110113861Medicare PIN
MA3146367Medicaid