| Dr Eba H Hathout, MD | |
| 
					300 Longwood Ave, Boston, MA 02115-5724  | |
| (617) 355-6000 | |
| Not Available | 
| Full Name | Dr Eba H Hathout | 
|---|---|
| Gender | Female | 
| Speciality | Pediatrics - Pediatric Endocrinology | 
| Location | 300 Longwood Ave, Boston, Massachusetts | 
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. | 
| Identifier | Type | State | Issuer | 
|---|---|---|---|
| 1487674792 | NPI | - | NPPES | 
| 00A485230 | Medicaid | CA | 
| Taxonomy | Type | License (State) | Status | 
|---|---|---|---|
| 2080P0205X | Pediatrics - Pediatric Endocrinology | 295077 (Massachusetts) | Primary | 
| Entity Name | Faculty Physicians And Surgeons Of Llusm | 
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice | 
| Entity Identifiers | NPI Number: 1205009917 PECOS PAC ID: 1153227814 Enrollment ID: O20031211000981  | 
| Mailing Address | Practice Location Address | 
|---|---|
| Dr Eba H Hathout, MD 300 Longwood Ave, Boston, MA 02115-5724 Ph: (617) 355-6000  | Dr Eba H Hathout, MD 300 Longwood Ave, Boston, MA 02115-5724 Ph: (617) 355-6000  | 
Puja Banka, M.D. Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 300 Longwood Ave, Bader 203, Boston, MA 02115 Phone: 617-355-6363  | |
Angela M. Jacques, MD Pediatrics Medicare: Medicare Enrolled Practice Location: Massachusetts General Hospital, 55 Fruit St., Boston, MA 02114 Phone: 617-726-2066  | |
Dr. Elizabeth S Taglauer, M.D., PH.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 300 Longwood Ave, Boston, MA 02115 Phone: 617-355-6000  | |
Cailyn Hereen Rood, MD Pediatrics Medicare: Accepting Medicare Assignments Practice Location: 300 Longwood Ave, Boston, MA 02115 Phone: 617-355-6000  | |
Dr. Alon Peltz, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 300 Longwood Ave, Boston, MA 02115 Phone: 617-355-6000  | |
Miki Nishitani, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 300 Longwood Ave, Boston, MA 02115 Phone: 617-355-6000  | |
Vickren Pillay, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 300 Longwood Ave, Boston, MA 02115 Phone: 617-355-6000  |