Provider Demographics
NPI:1649224502
Name:HORAN, JOHN T (MD MPH)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:T
Last Name:HORAN
Suffix:
Gender:M
Credentials:MD MPH
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:450 BROOKLINE AVENUE
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02215
Mailing Address - Country:US
Mailing Address - Phone:617-632-3270
Mailing Address - Fax:617-632-4410
Practice Address - Street 1:450 BROOKLINE AVENUE
Practice Address - Street 2:
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02215
Practice Address - Country:US
Practice Address - Phone:617-632-3270
Practice Address - Fax:617-632-4410
Is Sole Proprietor?:No
Enumeration Date:2006-05-22
Last Update Date:2019-08-01
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA2536202080P0207X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0207XAllopathic & Osteopathic PhysiciansPediatricsPediatric Hematology-Oncology