Provider Demographics
NPI:1932155207
Name:HOCHMAN, MARY GABRIELLA (MD)
Entity Type:Individual
Prefix:DR
First Name:MARY
Middle Name:GABRIELLA
Last Name:HOCHMAN
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Gender:F
Credentials:MD
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Mailing Address - Street 1:375 LONGWOOD AVE STE 3
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02215-5395
Mailing Address - Country:US
Mailing Address - Phone:617-632-7441
Mailing Address - Fax:617-632-7570
Practice Address - Street 1:330 BROOKLINE AVE
Practice Address - Street 2:BETH ISRAEL DEACONESS MEDICAL CENTER
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02215
Practice Address - Country:US
Practice Address - Phone:617-667-1283
Practice Address - Fax:617-667-8212
Is Sole Proprietor?:No
Enumeration Date:2006-05-26
Last Update Date:2018-06-18
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MA818312085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA3144038Medicaid
MA3144038Medicaid
MAG21618Medicare UPIN