IndividualActive
Ika Noviawaty, M.D.
NPI 1265675292 · Epilepsy Physician · Boston, MA
Provider details
- NPI number
- 1265675292
- Entity type
- Individual
- Primary specialty
- Epilepsy PhysicianAllopathic & Osteopathic Physicians
- Credential
- M.D.
- Sex
- Female
- Sole proprietor
- No
- License
- 265068 (MA)
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Allopathic & Osteopathic Physicians
Allopathic & Osteopathic Physicians
Practice location
725 Albany Street, Suite 7b
Shapiro Building
Boston, MA 02118
Phone: (617) 638-8456
Fax: (617) 638-8465
Approximate (ZIP-level) locationGet directions
Mailing address
960 Massachusetts Avenue
Boston, MA 02118
Registry dates
- Enumerated
- 2009-04-06
- Last updated
- 2024-07-08
- Certified
- 2023-09-15
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.