| Coralli R So, MD | |
|
585 Lebanon St, Radiology Department, Melrose, MA 02176-3225 | |
| (781) 979-3120 | |
| (781) 979-3994 |
| Full Name | Coralli R So |
|---|---|
| Gender | Female |
| Speciality | Diagnostic Radiology |
| Experience | 32 Years |
| Location | 585 Lebanon St, Melrose, Massachusetts |
| Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1801830153 | NPI | - | NPPES |
| 0196321 | Medicaid | MA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2085R0202X | Radiology - Diagnostic Radiology | 152261 (Massachusetts) | Secondary |
| 2085R0204X | Radiology - Vascular & Interventional Radiology | 152261 (Massachusetts) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Melrosewakefield Healthcare | Melrose, MA | Hospital |
| Lowell General Hospital | Lowell, MA | Hospital |
| Tufts Medical Center | Boston, MA | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Mw Radiology-cra Llc | 6406270040 | 41 |
| Merrimack Radiology-cra Llc | 8426287269 | 52 |
| Entity Name | Lgh Medical Group, Inc. |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1174698385 PECOS PAC ID: 3173626751 Enrollment ID: O20070320000453 |
| Entity Name | Commonwealth Radiology Associates Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1295711661 PECOS PAC ID: 2668468406 Enrollment ID: O20081210000048 |
| Entity Name | Merrimack Radiology-cra Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1275871154 PECOS PAC ID: 8426287269 Enrollment ID: O20140128000095 |
| Entity Name | Mw Radiology-cra Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1114555398 PECOS PAC ID: 6406270040 Enrollment ID: O20200716000148 |
| Mailing Address | Practice Location Address |
|---|---|
| Coralli R So, MD 244 W Newton St, Apartment #3, Boston, MA 02116-6405 Ph: (781) 979-3120 | Coralli R So, MD 585 Lebanon St, Radiology Department, Melrose, MA 02176-3225 Ph: (781) 979-3120 |
Joshua P Stein, M.D. Radiology Medicare: Accepting Medicare Assignments Practice Location: 585 Lebanon St, Hallmark Imaging, Melrose, MA 02176 Phone: 781-979-3117 Fax: 781-979-3994 | |
Nam Lee, Radiology Medicare: Medicare Enrolled Practice Location: 1 Oak Grove Ave, 132, Melrose, MA 02176 Phone: 781-620-1810 | |
Karl Eric Henrikson, MD Radiology Medicare: Not Enrolled in Medicare Practice Location: 585 Lebanon St, Radiology Department, Melrose, MA 02176 Phone: 781-979-3120 Fax: 781-979-3994 | |
Windy Kristen Matich, MD Radiology Medicare: Accepting Medicare Assignments Practice Location: 585 Lebanon St, Melrose, MA 02176 Phone: 724-984-8574 | |
Olga Efimova, MD Radiology Medicare: Accepting Medicare Assignments Practice Location: 585 Lebanon St, Radiology Department, Melrose, MA 02176 Phone: 781-979-3120 Fax: 781-979-3994 | |
Patrick D Oder, MD Radiology Medicare: Accepting Medicare Assignments Practice Location: 585 Lebanon St, Radiology Department, Melrose, MA 02176 Phone: 781-979-3120 Fax: 781-979-3994 |