Provider Demographics
NPI:1942469101
Name:ROH, JASON (MD)
Entity Type:Individual
Prefix:
First Name:JASON
Middle Name:
Last Name:ROH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:79 GAINSBOROUGH ST
Mailing Address - Street 2:UNIT 408
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02115-6516
Mailing Address - Country:US
Mailing Address - Phone:203-233-8788
Mailing Address - Fax:
Practice Address - Street 1:185 PILGRIM RD
Practice Address - Street 2:BAKER 4
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02215-5324
Practice Address - Country:US
Practice Address - Phone:617-632-7828
Practice Address - Fax:617-632-7536
Is Sole Proprietor?:No
Enumeration Date:2008-06-03
Last Update Date:2015-06-19
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA247055207R00000X, 207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease