Provider Demographics
NPI:1114909470
Name:HOCHBERG, FRED HARVEY (MD)
Entity Type:Individual
Prefix:DR
First Name:FRED
Middle Name:HARVEY
Last Name:HOCHBERG
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:PO BOX 9142
Mailing Address - Street 2:MASS GENERAL PHYSICIAN ORGANIZATION
Mailing Address - City:CHARLESTOWN
Mailing Address - State:MA
Mailing Address - Zip Code:02129-9142
Mailing Address - Country:US
Mailing Address - Phone:617-724-0287
Mailing Address - Fax:617-726-2894
Practice Address - Street 1:55 FRUIT ST
Practice Address - Street 2:YAW 9 BRAIN TUMOR CENTER NEURO ONCOLOGY
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02114-2621
Practice Address - Country:US
Practice Address - Phone:617-724-8770
Practice Address - Fax:617-248-9665
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-14
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MA364152084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAM09005OtherBCBS MA
MA2040085Medicaid
MA705077OtherTUFTS HEALTH PLAN
MA705077OtherTUFTS HEALTH PLAN
MA2040085Medicaid