| Boston University Medical Center | |
|
850 Harrison Ave # Acc5 The Adolescent Center Boston MA 02118-4001 | |
| (617) 414-4086 | |
| Not Available |
| Full Name | Boston University Medical Center |
|---|---|
| Speciality | Clinic/center - Primary Care |
| Location | 850 Harrison Ave # Acc5, Boston, Massachusetts |
| Authorized Official Name and Position | David Difiore (SENIOR FINANCIAL OFFICER) |
| Authorized Official Contact | 6174145170 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Boston University Medical Center 208 Algonquin Trl Ashland MA 01721-1993 Ph: (508) 309-3347 | Boston University Medical Center 850 Harrison Ave # Acc5 The Adolescent Center Boston MA 02118-4001 Ph: (617) 414-4086 |
| NPI Number | 1275564734 |
|---|---|
| Provider Enumeration Date | 07/05/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1275564734 | NPI | - | NPPES |
| 3005551 | Medicaid | MA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | 50604 (Massachusetts) | Primary |
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