EDYTA M KONRAD MD, PHD (NPI# 1417401993) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1417401993 |
| Entity Type | Organization |
| Organization Name | EDYTA M KONRAD MD, PHD |
| Practice Address |
320 Bolton St Ofiice # 100 Marlborough MA 01752-3988 |
| Practice Telephone | 5084606002 |
| Practice Fax Number | 5084606028 |
| Mailing Telephone | 5084606002 |
| Mailing Fax Number | 5084606028 |
| Enumeration Date | 2016-08-12 |
| Last Update Date | 2016-08-12 |
| Authorized Official Name | DR. EDYTA MARIA KONRAD (OWNER) |
| Authorized Official Telephone | 5084606002 |
| Authorized Official Credential | MD, PHD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 133NN1002X |
Nutritionist Specialization: Nutrition, Education |
Dietary & Nutritional Service Providers | ||
| N | 363L00000X | Nurse Practitioner | Physician Assistants & Advanced Practice Nursing Providers | ||
| Y | 207R00000X | Internal Medicine | 157585 | MA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MA | 110037908A | 05 |
| Street Address |
320 BOLTON ST OFIICE # 100 |
| City | MARLBOROUGH |
| State | MA |
| Zip Code | 01752-3988 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285628271 | Arnold J Hill Md PC | Internal Medicine | 320 Bolton St, Marlborough, MA 01752-3980 | 2005-09-06 |
| 1447796149 | Jacquelynne Anne Leighton | Nurse Practitioner | 320 Bolton St, Marlborough, MA 01752-3988 | 2017-01-18 |
| 1437559614 | Jennifer Vitti Haddad | Nurse Practitioner | 320 Bolton St, Marlborough, MA 01752-3988 | 2014-08-25 |
| 1851735179 | Margarita Menocal | Physical Therapist | 320 Bolton St, Ste G2, Marlborough, MA 01752-3988 | 2013-04-18 |
| 1336486869 | Bolton Street Pediatrics PC | Pediatrics | 320 Bolton St, Marlborough, MA 01752-3988 | 2013-01-03 |
| 1699011411 | Christine Blake Grabenstatter | Nurse Practitioner | 320 Bolton St, Marlborough, MA 01752-3988 | 2012-12-26 |
| 1558637371 | Excel Physical Therapy & Rehabilitation LLC | Physical Therapist | 320 Bolton St, Suite- G2, Marlborough, MA 01752-3988 | 2012-03-26 |
| 1275734535 | Marlborough Center for Sleep Disorders | Clinical Medical Laboratory | 320 Bolton St, Suite 100, Marlborough, MA 01752-3980 | 2007-05-31 |
| 1316155351 | Kristian L Bae | Dentist | 320 Bolton St, Marlborough, MA 01752-3980 | 2007-05-21 |
| 1902012941 | Won H Bae | Dentist | 320 Bolton St, Marlborough, MA 01752-3980 | 2007-05-15 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811597883 | Tiffany Marie Stewart | Behavior Technician | 255 Cedar Hill Street Suite 200, Marlborough, MA 01752 | 2020-10-29 |
| 1235754664 | Jessica Michelle Rudolph | Behavior Technician | 22 Cedar Hill Street, Suite 200, Marlborough, MA 01752 | 2020-06-11 |
| 1619501012 | Kady Potter | Behavioral Analyst | 225 Cedar Hill Street, Marlborough, MA 01752 | 2020-02-25 |
| 1639701113 | Cheyenne-lynn Charnik | Behavior Technician | 255 Cedar Hill St, Suite 200, Marlborough, MA 01752 | 2020-02-12 |
| 1063042711 | Nichole Lowder | Behavioral Analyst | 22 5 Cedar Hill Street Suite 200, Marlborough, MA 01752 | 2020-01-22 |
| 1164068649 | Ludiana Andrade | Behavioral Analyst | 225 Cedar Hill Street Suite 200, Marlborough, MA 01752 | 2019-11-20 |
| 1215583646 | Olivia Setzer | Behavior Technician | 225 Cedar Street, Suite 200, Marlborough, MA 01752 | 2019-08-12 |
| 1306490867 | Rachael Lee Pennachi | Behavior Technician | 225 Cedar Hill Street Ste 200, Marlborough, MA 01752 | 2019-08-01 |
| 1962964130 | Hero Therapy LLC | Behavioral Analyst | 11 Apex Dr Ste 300a, Marlborough, MA 01752 | 2019-04-04 |
| 1780190728 | Rachel Castleberry | Counselor | Advocates, 340 Maple Street 4th Floor, Marlborough, MA 01752 | 2017-12-28 |
| Find all providers in zip 01752 | ||||
| Taxonomy Code | 207R00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982010583 | Hugo Akabane | Internal Medicine | 8 Royal Crest Dr Apt 10, Marlborough, MA 01752-2478 | 2014-07-03 |
| 1184746257 | Marguerite M Brackley | Internal Medicine | 100 Boston Scientific Way, Marlborough, MA 01752-1234 | 2007-04-06 |
| 1417970526 | Jeffrey A. Scott | Internal Medicine | 126 Union St Ofc 1, Marlborough, MA 01752-1207 | 2006-07-26 |
| 1740207471 | Shunian He | Internal Medicine | 640 Bolton St, Marlborough, MA 01752-3999 | 2006-07-17 |
| 1255376182 | Elizabeth A Westphal | Internal Medicine | 488 Boston Post Rd E, Marlborough, MA 01752-3604 | 2006-06-17 |
| 1922040260 | Jane H Joiner | Internal Medicine | 246 Maple Street, Charles River Medical Associates, Marlborough, MA 01752-3235 | 2006-06-12 |
| 1538120589 | Dolly Geevarghese | Internal Medicine | 246 Maple St, Marlborough, MA 01752-3235 | 2006-03-29 |
| 1295796423 | Jose Roberto Flores Cardillo | Internal Medicine | 246 Maple St Ste 3, Marlborough, MA 01752-3235 | 2006-03-29 |
| 1972587822 | Neal I Muni | Internal Medicine | 84 Waterford Dr, Marlborough, MA 01752-7010 | 2005-12-05 |
| 1285628271 | Arnold J Hill Md PC | Internal Medicine | 320 Bolton St, Marlborough, MA 01752-3980 | 2005-09-06 |
| Find all providers in MARLBOROUGH | ||||
| City | MARLBOROUGH |
| Zip Code | 01752 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.