Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RH0000X | Hematologist | 39404 | MA |
NPI | 1407824659 |
---|---|
Provider Name | Jerome Ritz |
First Address | Boston, MA 02215-5418 |
Second Address | Boston, MA 02215-5418 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 14/03/2006 |
Last Update Date | 24/03/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
2067386 | AETNA US HEALTHCARE (01) | |
3004482 | UNITED HEALTH CARE (01) | |
50326 | FALLON COMMUNITY HEALTH (01) | |
5574325 | CIGNA (01) | |
6189024 | MASSHEALTH MEDICAID MA (01) | |
729824 | TUFTS (01) | |
B87143 | (02) | |
B87143DF | HPHC DFCI ONLY (01) |