Provider Demographics
NPI:1639638455
Name:MANN, EMILY A (MD)
Entity Type:Individual
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First Name:EMILY
Middle Name:A
Last Name:MANN
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Gender:F
Credentials:MD
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Mailing Address - Street 1:960 MASSACHUSETTS AVE
Mailing Address - Street 2:FL 2
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02118-2690
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:830 HARRISON AVE, 3RD FL
Practice Address - Street 2:MOAKLEY, HEMATOLOGY/ONCOLOGY
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02118-2905
Practice Address - Country:US
Practice Address - Phone:617-638-6428
Practice Address - Fax:617-638-5756
Is Sole Proprietor?:No
Enumeration Date:2019-03-19
Last Update Date:2024-04-10
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Provider Licenses
StateLicense IDTaxonomies
MA291389207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA110155193AMedicaid
NH3135902Medicaid