Provider Demographics
NPI:1851452551
Name:BORAL, ANTHONY L (MD)
Entity Type:Individual
Prefix:
First Name:ANTHONY
Middle Name:L
Last Name:BORAL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:31 LOPEZ ST
Mailing Address - Street 2:
Mailing Address - City:CAMBRIDGE
Mailing Address - State:MA
Mailing Address - Zip Code:02139-4061
Mailing Address - Country:US
Mailing Address - Phone:617-444-1351
Mailing Address - Fax:
Practice Address - Street 1:MILLENNIUM PHARM.
Practice Address - Street 2:40 LANDSDOWNE ST.
Practice Address - City:CAMBRIDGE
Practice Address - State:MA
Practice Address - Zip Code:02139
Practice Address - Country:US
Practice Address - Phone:617-444-1351
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA150057207RX0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RX0202XAllopathic & Osteopathic PhysiciansInternal MedicineMedical Oncology