| Eugenia Chan, MD | |
|
133 Brookline Ave, Boston, MA 02215-3904 | |
| (617) 421-1000 | |
| (617) 421-6084 |
| Full Name | Eugenia Chan |
|---|---|
| Gender | Female |
| Speciality | Pediatrics - Developmental - Behavioral Pediatrics |
| Location | 133 Brookline 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 |
|---|---|---|---|
| 1215997192 | NPI | - | NPPES |
| 3199681 | Medicaid | MA | |
| J21142 | Other | MA | BLUE CROSS |
| AA17606 | Other | MA | HARVARD PILGRIM |
| 0015203 | Other | MA | NEIGHBORHOOD HEALTH |
| 156686 | Other | MA | TUFTS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208000000X | Pediatrics | 156686 (Massachusetts) | Secondary |
| 2080P0006X | Pediatrics - Developmental - Behavioral Pediatrics | 156686 (Massachusetts) | Primary |
| Entity Name | Children's Hospital Pediatric Associates, Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1457306664 PECOS PAC ID: 3476541830 Enrollment ID: O20040504000964 |
| Mailing Address | Practice Location Address |
|---|---|
| Eugenia Chan, MD 147 Milk St, Provider Enrollment - 9th Floor, Boston, MA 02109-4806 Ph: (617) 559-8053 | Eugenia Chan, MD 133 Brookline Ave, Boston, MA 02215-3904 Ph: (617) 421-1000 |
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 |