Noronha, Ansu Mammen

Noronha, Ansu Mammen is an individual health care provider with primary practice located at 725 Albany St, Fl 6 Shapiro Bldg - Gastroenterology, Boston MA 02118. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Internal Medicine, Allopathic & Osteopathic Physicians / Gastroenterology. Allopathic & Osteopathic Physicians / Gastroenterology is her primary health care specialty. Noronha, Ansu Mammen can be contacted via phone (617) 414-6525.

Contact Information

Primary practice address
725 Albany St, Fl 6 Shapiro Bldg - Gastroenterology Boston MA 02118
Phone: (617) 414-6525
Fax: (617) 638-7448
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X 226565 Massachusetts
Allopathic & Osteopathic Physicians / Gastroenterology 207RG0100X 226565 Massachusetts

Profile Details

NPI number 1568557775
LBN Legal business name Noronha, Ansu Mammen
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 4th, 2006
Last updated Jun 28th, 2024 - about 2 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1568557775 NPPES
Massachusetts MEDICAID 110083854A
Massachusetts MEDICAID 3115956

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