Provider Demographics
NPI:1871675694
Name:HEMATOLOGY ONCOLOGY SPECIALISTS OF CAPE COD, P.C.
Entity Type:Organization
Organization Name:HEMATOLOGY ONCOLOGY SPECIALISTS OF CAPE COD, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:VICTOR
Authorized Official - Middle Name:M
Authorized Official - Last Name:AVILES
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:508-540-1163
Mailing Address - Street 1:120 JONES RD
Mailing Address - Street 2:SUITE 2-5
Mailing Address - City:FALMOUTH
Mailing Address - State:MA
Mailing Address - Zip Code:02540-2904
Mailing Address - Country:US
Mailing Address - Phone:508-540-1163
Mailing Address - Fax:508-540-7550
Practice Address - Street 1:120 JONES RD
Practice Address - Street 2:SUITE 2-5
Practice Address - City:FALMOUTH
Practice Address - State:MA
Practice Address - Zip Code:02540-2904
Practice Address - Country:US
Practice Address - Phone:508-540-1163
Practice Address - Fax:508-540-7550
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-20
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA210733207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & OncologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA453027OtherTUFTS INDIV PROV #
MAGROUP PROV # PENDINGMedicaid
MAJ24050OtherBLUE SHIELD OF MA INDIV.
MAAA69996OtherHARVARD PILGRIM HLTH CARE
MAGROUP # PENDINGOtherTUFTS GROUP #
MA5329445OtherAETNA INDIV PROV #
MA7881833OtherAETNA
MA9718309OtherCIGNA INDIV PROV #
MAM19270OtherBLUE SHIELD OF MA GROUP #
MAGROUP # PENDINGOtherTUFTS GROUP #
MAGROUP # PENDINGOtherTUFTS GROUP #
MA=========OtherUNITED HLTH CARE ID
MAA32885Medicare ID - Type UnspecifiedINDIVIDUAL PROV #