Provider Demographics
NPI:1861469249
Name:ANTIN, JOSEPH HARRY (MD)
Entity Type:Individual
Prefix:
First Name:JOSEPH
Middle Name:HARRY
Last Name:ANTIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:44 BINNEY ST
Mailing Address - Street 2:DANA-FARBER CANCER INSTITUTE
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02115-6013
Mailing Address - Country:US
Mailing Address - Phone:617-632-3667
Mailing Address - Fax:617-632-5175
Practice Address - Street 1:44 BINNEY ST
Practice Address - Street 2:DANA-FARBER CANCER INSTITUTE
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02115-6013
Practice Address - Country:US
Practice Address - Phone:617-632-3667
Practice Address - Fax:617-632-5175
Is Sole Proprietor?:No
Enumeration Date:2006-03-03
Last Update Date:2017-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA55573207RH0000X, 207RX0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RX0202XAllopathic & Osteopathic PhysiciansInternal MedicineMedical Oncology
No207RH0000XAllopathic & Osteopathic PhysiciansInternal MedicineHematology
Provider Identifiers
StateIdentifier IDID TypeIssuer
6165583OtherMASSHEALTH
900001634OtherRR MEDICARE DFCI
B74187DFOtherHPHC DFCI ONLY
3000386OtherUNITED HEALTH CARE
3882OtherFALLON COMMUNITY HEALTH P
9844546OtherCIGNA
MAJ02217OtherBLUE CROSS BLUE SHIELD
055573OtherTUFTS
2061004OtherAETNA US HEALTHCARE
J02217Medicare ID - Type Unspecified
3882OtherFALLON COMMUNITY HEALTH P