Provider Demographics
NPI:1033105754
Name:ROMANELLI, DONALD FRANCIS (MD)
Entity Type:Individual
Prefix:
First Name:DONALD
Middle Name:FRANCIS
Last Name:ROMANELLI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:31 SMITH PLACE
Mailing Address - Street 2:SCHATZKI ASSOCIATES
Mailing Address - City:CAMBRIDGE
Mailing Address - State:MA
Mailing Address - Zip Code:02138
Mailing Address - Country:US
Mailing Address - Phone:617-661-1949
Mailing Address - Fax:
Practice Address - Street 1:330 MOUNT AUBURN STREET
Practice Address - Street 2:MOUNT AUBURN HOSPITAL
Practice Address - City:CAMBRIDGE
Practice Address - State:MA
Practice Address - Zip Code:02138
Practice Address - Country:US
Practice Address - Phone:617-492-3500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-09-27
Last Update Date:2012-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA0749122085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAJ30559OtherBLUE SHIELD OF MASS
MA110054481AMedicaid
MAJ30559OtherBLUE SHIELD OF MASS