NPI 1104718402 · live from the CMS NPI Registry
Mohammed Azib M Alqahtani
Psychiatry & Neurology, Epilepsy in Boston, MA. National Provider Identifier 1104718402, active.
NPI record
| NPI | 1104718402 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Psychiatry & Neurology, Epilepsy 2084E0001X |
| Practice location | 300 Longwood Ave # Fegan11, Boston, MA 02115 |
| Practice phone | 617-355-8735 |
| Enumerated | July 19, 2025 |
| Last updated | July 19, 2025 |
| Sole proprietor | No |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Psychiatry & Neurology, Neurology with Special Qualifications in Child Neurology | 2084N0402X | 3017839 (MA) |
| Psychiatry & Neurology, Epilepsy primary | 2084E0001X | 3017839 (MA) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.