Provider Demographics
NPI:1265498000
Name:MAMON, HARVEY JAY (MD, PHD)
Entity Type:Individual
Prefix:DR
First Name:HARVEY
Middle Name:JAY
Last Name:MAMON
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Gender:M
Credentials:MD, PHD
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Mailing Address - Street 1:75 FRANCIS ST
Mailing Address - Street 2:BRIGHAM AND WOMEN'S HOSPITAL, RADIATION ONCOLOGY
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02115-6110
Mailing Address - Country:US
Mailing Address - Phone:617-732-7906
Mailing Address - Fax:617-264-5242
Practice Address - Street 1:BRIGHAM AND WOMEN'S HOSPITAL, RADIATION ON
Practice Address - Street 2:75 FRANCIS STREET, ASB1-L2
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02115-6110
Practice Address - Country:US
Practice Address - Phone:617-732-7906
Practice Address - Fax:617-264-5242
Is Sole Proprietor?:No
Enumeration Date:2006-04-21
Last Update Date:2015-08-20
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Provider Licenses
StateLicense IDTaxonomies
MA157398174400000X, 2085R0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation Oncology
No174400000XOther Service ProvidersSpecialist