Provider Demographics
NPI:1205803913
Name:NEW ENGLAND HEMATOLOGY ONCOLOGY ASSOCIATES, PC
Entity type:Organization
Organization Name:NEW ENGLAND HEMATOLOGY ONCOLOGY ASSOCIATES, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINSTRATIVE DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:AMY
Authorized Official - Middle Name:
Authorized Official - Last Name:CARLTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:617-658-6000
Mailing Address - Street 1:2014 WASHINGTON STREET
Mailing Address - Street 2:VERNON CANCER CENTER
Mailing Address - City:NEWTON
Mailing Address - State:MA
Mailing Address - Zip Code:02462-1607
Mailing Address - Country:US
Mailing Address - Phone:617-658-6000
Mailing Address - Fax:617-658-6001
Practice Address - Street 1:2014 WASHINGTON ST
Practice Address - Street 2:VERNON CANCER CENTER
Practice Address - City:NEWTON
Practice Address - State:MA
Practice Address - Zip Code:02462-1607
Practice Address - Country:US
Practice Address - Phone:617-658-6000
Practice Address - Fax:617-658-6001
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-01
Last Update Date:2015-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA110068522AMedicaid
MA9722017Medicaid
MAM13462Medicare PIN