Provider Demographics
NPI:1538857545
Name:LALITNITHI, PAKIN (MD)
Entity type:Individual
Prefix:MR
First Name:PAKIN
Middle Name:
Last Name:LALITNITHI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:736 CAMBRIDGE STREET BRIGHTON
Mailing Address - Street 2:CRB BUILDING, 1ST FLOOR-ROOM 115
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02135
Mailing Address - Country:US
Mailing Address - Phone:617-789-3000
Mailing Address - Fax:617-789-2438
Practice Address - Street 1:736 CAMBRIDGE STREET, BRIGHTON
Practice Address - Street 2:
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02135
Practice Address - Country:US
Practice Address - Phone:617-789-3000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-04-27
Last Update Date:2024-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
MA3014799207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program