Provider Demographics
NPI:1750419727
Name:OCCUPATIONAL AND ENVIRONMENTAL MEDICINE SPECIALISTS
Entity type:Organization
Organization Name:OCCUPATIONAL AND ENVIRONMENTAL MEDICINE SPECIALISTS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:C
Authorized Official - Last Name:CHRISTIANI
Authorized Official - Suffix:
Authorized Official - Credentials:MD, MPH, MS
Authorized Official - Phone:781-952-2445
Mailing Address - Street 1:40 LOUDERS LN
Mailing Address - Street 2:
Mailing Address - City:JAMAICA PLAIN
Mailing Address - State:MA
Mailing Address - Zip Code:02130-3423
Mailing Address - Country:US
Mailing Address - Phone:781-952-2445
Mailing Address - Fax:781-952-2303
Practice Address - Street 1:2001 WASHINGTON ST
Practice Address - Street 2:COEM KINDRED HOSPITAL NORTHEAST - BRAINTREE
Practice Address - City:BRAINTREE
Practice Address - State:MA
Practice Address - Zip Code:02184-8658
Practice Address - Country:US
Practice Address - Phone:781-952-2445
Practice Address - Fax:781-952-2303
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-01
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA42822261QX0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QX0100XAmbulatory Health Care FacilitiesClinic/CenterOccupational Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD609346OtherHARVARD PILGRIM
MA9767606Medicaid
MDM15463OtherBLUE CROSS BLUE SHIELD
MD601388OtherTUFTS
MD609346OtherHARVARD PILGRIM