Provider Demographics
NPI:1023151743
Name:CHRISTOS A.HASIOTIS,MD.PC
Entity type:Organization
Organization Name:CHRISTOS A.HASIOTIS,MD.PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:CHRISTOS
Authorized Official - Middle Name:A
Authorized Official - Last Name:HASIOTIS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:617-864-3800
Mailing Address - Street 1:725 CONCORD AVE
Mailing Address - Street 2:SUITE 4500
Mailing Address - City:CAMBRIDGE
Mailing Address - State:MA
Mailing Address - Zip Code:02138-1040
Mailing Address - Country:US
Mailing Address - Phone:617-864-3800
Mailing Address - Fax:
Practice Address - Street 1:725 CONCORD AVE
Practice Address - Street 2:SUITE 4500
Practice Address - City:CAMBRIDGE
Practice Address - State:MA
Practice Address - Zip Code:02138-1040
Practice Address - Country:US
Practice Address - Phone:617-864-3800
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-14
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA27876174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA9726179Medicaid
MA9726179Medicaid
MAM05001Medicare ID - Type Unspecified