Provider Demographics
NPI:1851302889
Name:JAVIER, MARICOR CRISTINA CASTILLO (MD)
Entity Type:Individual
Prefix:
First Name:MARICOR CRISTINA
Middle Name:CASTILLO
Last Name:JAVIER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:MARICOR CRISTINA
Other - Middle Name:ANGELES
Other - Last Name:CASTILLO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:780 BOYLSTON ST
Mailing Address - Street 2:SPT. 5-I
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02199-7820
Mailing Address - Country:US
Mailing Address - Phone:646-321-8858
Mailing Address - Fax:
Practice Address - Street 1:BOSTON MEDICAL CENTER
Practice Address - Street 2:ONE BOSTON MEDICAL PLACE -DOWLING 3 SOUTH
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02118
Practice Address - Country:US
Practice Address - Phone:617-414-3697
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-11
Last Update Date:2021-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2273012080N0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080N0001XAllopathic & Osteopathic PhysiciansPediatricsNeonatal-Perinatal Medicine