Provider Demographics
NPI:1528058625
Name:AGNIHOTRI, ARVIND K (MD)
Entity type:Individual
Prefix:DR
First Name:ARVIND
Middle Name:K
Last Name:AGNIHOTRI
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:960 MASSACHUSETTS AVENUE
Mailing Address - Street 2:FL 2
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02118-2690
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:11 NEVINS ST
Practice Address - Street 2:SUITE 306
Practice Address - City:BRIGHTON
Practice Address - State:MA
Practice Address - Zip Code:02135-3514
Practice Address - Country:US
Practice Address - Phone:617-789-2045
Practice Address - Fax:617-789-2932
Is Sole Proprietor?:No
Enumeration Date:2005-10-28
Last Update Date:2025-03-05
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA204229208600000X, 208G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)
No208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA3205126Medicaid
MA204229OtherTUFTS HEALTH PLAN
MAJ22001OtherBCBS MA
F75563Medicare UPIN
MA204229OtherTUFTS HEALTH PLAN