Provider Demographics
NPI:1659362291
Name:BUONANNO, FERDINANDO S (MD)
Entity Type:Individual
Prefix:DR
First Name:FERDINANDO
Middle Name:S
Last Name:BUONANNO
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Gender:M
Credentials:MD
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Mailing Address - Street 1:PO BOX 9142
Mailing Address - Street 2:MASS GENERAL PHYSICIAN ORGANIZATION
Mailing Address - City:CHARLESTOWN
Mailing Address - State:MA
Mailing Address - Zip Code:02129-9142
Mailing Address - Country:US
Mailing Address - Phone:617-724-0287
Mailing Address - Fax:617-726-2894
Practice Address - Street 1:15 PARKMAN ST
Practice Address - Street 2:ACC720 NEUROLOGY ASSOCIATES
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02114-3117
Practice Address - Country:US
Practice Address - Phone:617-726-8459
Practice Address - Fax:617-726-5043
Is Sole Proprietor?:No
Enumeration Date:2005-11-02
Last Update Date:2011-10-22
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Provider Licenses
StateLicense IDTaxonomies
MA446132084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAE05188OtherBCBS MA
MA703787OtherTUFTS HEALTH PLAN
MA0140198Medicaid
B97522Medicare UPIN
MA0140198Medicaid