Provider Demographics
NPI:1710954391
Name:ENZINGER, PETER C (DR)
Entity Type:Individual
Prefix:MR
First Name:PETER
Middle Name:C
Last Name:ENZINGER
Suffix:
Gender:M
Credentials:DR
Other - Prefix:
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Mailing Address - Street 1:11 DANE ST
Mailing Address - Street 2:
Mailing Address - City:JAMAICA PLAIN
Mailing Address - State:MA
Mailing Address - Zip Code:02130
Mailing Address - Country:US
Mailing Address - Phone:617-632-6855
Mailing Address - Fax:617-632-5370
Practice Address - Street 1:44 BINNEY ST
Practice Address - Street 2:DANA-FARBER CANCER INST
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02115-6013
Practice Address - Country:US
Practice Address - Phone:617-632-6855
Practice Address - Fax:617-632-5370
Is Sole Proprietor?:No
Enumeration Date:2006-03-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA160952207RX0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RX0202XAllopathic & Osteopathic PhysiciansInternal MedicineMedical Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
51279OtherFALLON COMMUNITY HEALTH P
406922OtherTUFTS
J21466OtherMASSACHUSETTS BCBS
2533518OtherAETNA US HEALTHCARE
MA3197034OtherMASSHEALTH
14930OtherHPHC
3147617OtherCIGNA
J21466OtherMASSACHUSETTS BCBS
51279OtherFALLON COMMUNITY HEALTH P