Provider Demographics
NPI:1912201138
Name:BOSTON UROLOGY INSTITUTE, LLC
Entity Type:Organization
Organization Name:BOSTON UROLOGY INSTITUTE, LLC
Other - Org Name:AIU/BIDPO
Other - Org Type:Other Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:J
Authorized Official - Last Name:CURRAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:781-762-0471
Mailing Address - Street 1:825 WASHINGTON ST
Mailing Address - Street 2:SUITE 360
Mailing Address - City:NORWOOD
Mailing Address - State:MA
Mailing Address - Zip Code:02062-3441
Mailing Address - Country:US
Mailing Address - Phone:781-762-0471
Mailing Address - Fax:
Practice Address - Street 1:825 WASHINGTON ST
Practice Address - Street 2:SUITE 360
Practice Address - City:NORWOOD
Practice Address - State:MA
Practice Address - Zip Code:02062-3441
Practice Address - Country:US
Practice Address - Phone:781-762-0471
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-01-03
Last Update Date:2011-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208800000XAllopathic & Osteopathic PhysiciansUrologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA0018395Medicare PIN