Provider Demographics
NPI:1538127873
Name:ZORN, JOSEPH B (MD)
Entity Type:Individual
Prefix:
First Name:JOSEPH
Middle Name:B
Last Name:ZORN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:147 MILK ST
Mailing Address - Street 2:PROVIDER ENROLLMENT - 9TH FLOOR
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02109-4806
Mailing Address - Country:US
Mailing Address - Phone:617-559-8374
Mailing Address - Fax:617-421-3487
Practice Address - Street 1:1611 CAMBRIDGE ST
Practice Address - Street 2:
Practice Address - City:CAMBRIDGE
Practice Address - State:MA
Practice Address - Zip Code:02138-4302
Practice Address - Country:US
Practice Address - Phone:617-661-5405
Practice Address - Fax:617-661-5226
Is Sole Proprietor?:No
Enumeration Date:2006-05-03
Last Update Date:2011-05-25
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MA31727207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA3196275Medicaid
MA0016471OtherNEIGHBORHOOD HEALTH
MAM245OtherHARVARD PILGRIM
MAM07559OtherBLUE CROSS
MA031727OtherTUFTS
MAM245OtherHARVARD PILGRIM
MAM07559Medicare PIN