Provider Demographics
NPI:1457310393
Name:KOHANE, DANIEL SOLOMON (MD PHD)
Entity Type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:SOLOMON
Last Name:KOHANE
Suffix:
Gender:M
Credentials:MD PHD
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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 STREET ELL 3
Practice Address - Street 2:PEDIATRIC CRITICAL CARE UNIT
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02114-2696
Practice Address - Country:US
Practice Address - Phone:617-724-4380
Practice Address - Fax:617-724-4391
Is Sole Proprietor?:No
Enumeration Date:2006-03-20
Last Update Date:2015-09-01
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Provider Licenses
StateLicense IDTaxonomies
MA77883207L00000X, 208000000X, 2080P0203X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0203XAllopathic & Osteopathic PhysiciansPediatricsPediatric Critical Care Medicine
No207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
No208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA3169138Medicaid
MA077883OtherTUFTS HEALTH PLAN
MAJ17903OtherBCBS MA
MA3169138Medicaid
G49658Medicare UPIN