Anisa Mnyusiwalla, B.SC., M.D.

Primary specialty

Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X

License

239326 Issued in MA

Practice address

75 Francis St
Department of Radiology
Boston, MA 02115-6110

Phone

(617) 732-6269

NPI assigned

Jul 22, 2009

Last updated

Jul 22, 2009By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1248220800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1248220800000",
    "number": "1073743159",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1443 BEACON ST",
            "address_2": "APT 709",
            "city": "BROOKLINE",
            "state": "MA",
            "postal_code": "024464707",
            "telephone_number": "617-699-0886"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "75 FRANCIS ST",
            "address_2": "DEPARTMENT OF RADIOLOGY",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021156110",
            "telephone_number": "617-732-6269"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MNYUSIWALLA",
        "first_name": "ANISA",
        "name_prefix": "Dr.",
        "credential": "B.SC., M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-07-22",
        "last_updated": "2009-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "MA",
            "license": "239326",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kaoru Annette Mizuguchi, MD PHD MMSC
• Keiko Mizuguchi, LMHC
• Hide Mizuno
• Domagoj Mladinov
• Gevork N Mnatzakanian, M.D.
• Allen Mo, MD
• Clifton Craig Mo, M.D.
• Michelle Mo, M.D., PH.D.
• Emma Moar
• Andrew Ayman Moawad, DMD

• Student in an Organized Health Care Education/Training Program in Boston, MA
• Providers in Boston, MA by specialty
• Student in an Organized Health Care Education/Training Program in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.