Provider Demographics
NPI:1639150592
Name:RESIL, CLAUDE (MD)
Entity Type:Individual
Prefix:DR
First Name:CLAUDE
Middle Name:
Last Name:RESIL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 366251
Mailing Address - Street 2:
Mailing Address - City:HYDE PARK
Mailing Address - State:MA
Mailing Address - Zip Code:02136-0023
Mailing Address - Country:US
Mailing Address - Phone:617-298-8304
Mailing Address - Fax:617-298-8300
Practice Address - Street 1:2110 DORCHESTER AVE
Practice Address - Street 2:SETON MEDICAL BUILDING, SUITE 205
Practice Address - City:DORCHESTER
Practice Address - State:MA
Practice Address - Zip Code:02124-5628
Practice Address - Country:US
Practice Address - Phone:617-298-8304
Practice Address - Fax:617-298-8300
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-08
Last Update Date:2013-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA159900207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA110062563AMedicaid
MAA30849Medicare ID - Type Unspecified
MAH13912Medicare UPIN