Provider Demographics
NPI:1508082710
Name:SALTZ SCHULMAN & GERSHENGORN PTR CARDIOLOGY ASSOCIATES
Entity Type:Organization
Organization Name:SALTZ SCHULMAN & GERSHENGORN PTR CARDIOLOGY ASSOCIATES
Other - Org Name:CARDIOLOGY ASSOCIATES OF GREATER BOSTON
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGING PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:B
Authorized Official - Last Name:SALTZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:617-738-1961
Mailing Address - Street 1:1101 BEACON ST FL 4
Mailing Address - Street 2:
Mailing Address - City:BROOKLINE
Mailing Address - State:MA
Mailing Address - Zip Code:02446-5587
Mailing Address - Country:US
Mailing Address - Phone:617-738-1961
Mailing Address - Fax:
Practice Address - Street 1:1101 BEACON ST FL 4
Practice Address - Street 2:
Practice Address - City:BROOKLINE
Practice Address - State:MA
Practice Address - Zip Code:02446-5587
Practice Address - Country:US
Practice Address - Phone:617-738-1961
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-17
Last Update Date:2010-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA261QM1300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MACAM11041OtherBCBS OF MASS
MACAM11041OtherRAILROAD MEDICARE
MA2004151Medicaid
MA6696OtherUS HEALTHCARE
MA600697OtherTUFTS
MA2004151Medicaid