Provider Demographics
NPI:1659436814
Name:GREATER BOSTON INTERNAL MEDICINE, PC
Entity Type:Organization
Organization Name:GREATER BOSTON INTERNAL MEDICINE, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:AGOSTINO
Authorized Official - Middle Name:
Authorized Official - Last Name:IARROBINO
Authorized Official - Suffix:JR
Authorized Official - Credentials:DO
Authorized Official - Phone:781-326-1464
Mailing Address - Street 1:200 PROVIDENCE HWY
Mailing Address - Street 2:
Mailing Address - City:DEDHAM
Mailing Address - State:MA
Mailing Address - Zip Code:02026-1881
Mailing Address - Country:US
Mailing Address - Phone:781-326-1464
Mailing Address - Fax:781-326-2230
Practice Address - Street 1:200 PROVIDENCE HWY
Practice Address - Street 2:
Practice Address - City:DEDHAM
Practice Address - State:MA
Practice Address - Zip Code:02026-1881
Practice Address - Country:US
Practice Address - Phone:781-326-1464
Practice Address - Fax:781-326-2230
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-27
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty