Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RH0000X | Hematologist | 80772 | MA |
Y | 207RX0202X | Medical Oncology | 80772 | MA |
NPI | 1225028137 |
---|---|
Provider Name | Dr. Lawrence Scott Blaszkowsky |
First Address | Charlestown, MA 02129-9142 |
Second Address | Boston, MA 02114-2621 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/10/2005 |
Last Update Date | 15/10/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
080772 | TUFTS HEALTH PLAN (01) | MA |
3153151 | (05) | MA |
G30461 | (02) | |
J16683 | BCBS MA (01) | MA |