Provider Demographics
NPI:1730385493
Name:BOSTON HEMATOLOGY & ONCOLOGY
Entity type:Organization
Organization Name:BOSTON HEMATOLOGY & ONCOLOGY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN-OWNER
Authorized Official - Prefix:
Authorized Official - First Name:EDWARD
Authorized Official - Middle Name:C
Authorized Official - Last Name:DOW
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:617-277-9696
Mailing Address - Street 1:125 PARKER HILL AVE
Mailing Address - Street 2:SUITE 380
Mailing Address - City:ROXBURY CROSSING
Mailing Address - State:MA
Mailing Address - Zip Code:02120-2847
Mailing Address - Country:US
Mailing Address - Phone:617-277-9696
Mailing Address - Fax:617-277-9229
Practice Address - Street 1:125 PARKER HILL AVE
Practice Address - Street 2:SUITE 380
Practice Address - City:ROXBURY CROSSING
Practice Address - State:MA
Practice Address - Zip Code:02120-2847
Practice Address - Country:US
Practice Address - Phone:617-277-9696
Practice Address - Fax:617-277-9229
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-21
Last Update Date:2008-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA59945207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & OncologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAM16912OtherBCBS
MA3112152Medicaid
MAF61459Medicare UPIN
MA3112152Medicaid