Provider Demographics
NPI:1225079940
Name:DANA FARBER CANCER INSTITUTE
Entity Type:Organization
Organization Name:DANA FARBER CANCER INSTITUTE
Other - Org Name:BOUTIQUE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR OF PATIENT ACCOUNTING
Authorized Official - Prefix:MS
Authorized Official - First Name:CELESTE
Authorized Official - Middle Name:C
Authorized Official - Last Name:DAYE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:617-632-3935
Mailing Address - Street 1:PO BOX 9101
Mailing Address - Street 2:
Mailing Address - City:BROOKLINE
Mailing Address - State:MA
Mailing Address - Zip Code:02447-9101
Mailing Address - Country:US
Mailing Address - Phone:617-632-3935
Mailing Address - Fax:617-632-4620
Practice Address - Street 1:44 BINNEY STREET
Practice Address - Street 2:
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02115
Practice Address - Country:US
Practice Address - Phone:617-632-3000
Practice Address - Fax:617-632-4620
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:DANA FARBER CANCER INSTITUE
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-06-10
Last Update Date:2007-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA397454OtherBCBS MA
MA1202383Medicaid
MA699114OtherTUFTS
MAAA18050OtherHPHC
MA699114OtherTUFTS