Provider Demographics
NPI:1891034492
Name:BOSTON MATERNAL-FETAL MEDICINE, LLC
Entity Type:Organization
Organization Name:BOSTON MATERNAL-FETAL MEDICINE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:BENJAMIN
Authorized Official - Middle Name:
Authorized Official - Last Name:HAMAR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:617-823-4191
Mailing Address - Street 1:1 BROOKLINE PL
Mailing Address - Street 2:SUITE 301
Mailing Address - City:BROOKLINE
Mailing Address - State:MA
Mailing Address - Zip Code:02445-7224
Mailing Address - Country:US
Mailing Address - Phone:617-264-0364
Mailing Address - Fax:617-264-0365
Practice Address - Street 1:1 BROOKLINE PL
Practice Address - Street 2:SUITE 301
Practice Address - City:BROOKLINE
Practice Address - State:MA
Practice Address - Zip Code:02445-7224
Practice Address - Country:US
Practice Address - Phone:617-264-0364
Practice Address - Fax:617-264-0365
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:BOSTON MFM
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2013-02-04
Last Update Date:2013-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207VM0101XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyMaternal & Fetal MedicineGroup - Single Specialty
No261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical SpecialtyGroup - Single Specialty