Provider Demographics
NPI:1952559189
Name:M.BERN HEMATOLOGY-ONCOLOGY, PC
Entity type:Organization
Organization Name:M.BERN HEMATOLOGY-ONCOLOGY, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING REPRESENTATIVE
Authorized Official - Prefix:
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:M
Authorized Official - Last Name:CORBETT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:207-497-2996
Mailing Address - Street 1:541 MASON BAY RD
Mailing Address - Street 2:
Mailing Address - City:JONESPORT
Mailing Address - State:ME
Mailing Address - Zip Code:04649-3501
Mailing Address - Country:US
Mailing Address - Phone:207-497-2996
Mailing Address - Fax:
Practice Address - Street 1:61 LINCOLN ST
Practice Address - Street 2:SUITE 308
Practice Address - City:FRAMINGHAM
Practice Address - State:MA
Practice Address - Zip Code:01702-8264
Practice Address - Country:US
Practice Address - Phone:508-620-0465
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-08-29
Last Update Date:2008-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MAMA34117207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & OncologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA7799223OtherCIGNA
MA1952559189OtherUNITED HEALTH CARE
MA1952559189OtherTRICARE
MA693116OtherTUFTS
MA1952559189OtherBCBS
MA1952559189OtherAETNA
MA1952559189OtherHARVARD PILGRIM