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Physicians Pediatrics Pediatric Critical Care Medicine

Provider NPI: 1831268754

Organization Information:
Organization is not Subpart
Authorized Official:  PAUL R HICKEY  ANESTHESIOLOGIST -IN-CHIEF  617-355-7267

Practice Location:
300 LONGWOOD AVE  BOSTON, MA 02115-5724 US
Tel: 617-919-1340  Fax: 617-919-1347

Business Mailing Address:
PO BOX 843069  BOSTON, MA 02284-3069 US
Tel: 617-919-1340  Fax: 617-919-1347

NPI Information:
NPI: 1831268754
Entity Type: Organization


PrimaryCodeCategory/DescriptionStateLicense Number
Pediatric Critical Care Medicine
Y174400000XOther Service Providers

Other Provider Identifiers:


American Medical Association 2012 taxonomy code information

Code: 174400000X





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