Provider Demographics
NPI:1114976396
Name:CASAL, JORGE E (MD)
Entity Type:Individual
Prefix:DR
First Name:JORGE
Middle Name:E
Last Name:CASAL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:165 CAMBRIDGE ST
Mailing Address - Street 2:SUITE 501
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02114
Mailing Address - Country:US
Mailing Address - Phone:617-726-4900
Mailing Address - Fax:617-228-6306
Practice Address - Street 1:165 CAMBRIDGE ST
Practice Address - Street 2:SUITE 501
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02114
Practice Address - Country:US
Practice Address - Phone:617-726-4900
Practice Address - Fax:617-228-6306
Is Sole Proprietor?:No
Enumeration Date:2006-05-08
Last Update Date:2014-02-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA154910207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
154910OtherTUFTS
MA3174878Medicaid
J18578OtherBLUE CROSS
66856OtherHARVARD PILGRIM
A23513Medicare PIN
G67176Medicare UPIN