Provider Demographics
NPI:1366741589
Name:EVEREST HEALTH CARE SPECIALISTS PLLC
Entity type:Organization
Organization Name:EVEREST HEALTH CARE SPECIALISTS PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROVIDER
Authorized Official - Prefix:DR
Authorized Official - First Name:BISHAL
Authorized Official - Middle Name:KANTA
Authorized Official - Last Name:MAINALI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:781-777-2320
Mailing Address - Street 1:142 LAKE ST # 2
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:MA
Mailing Address - Zip Code:02474-8874
Mailing Address - Country:US
Mailing Address - Phone:781-777-2320
Mailing Address - Fax:781-777-1652
Practice Address - Street 1:142 LAKE ST
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:MA
Practice Address - Zip Code:02474-8874
Practice Address - Country:US
Practice Address - Phone:781-777-2320
Practice Address - Fax:781-777-1652
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-03-28
Last Update Date:2015-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA230502207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA213454Medicaid
MA213454Medicaid