| Boston Specialists - South Shore Llc | |
|
75 Kneeland St Fl 1 Boston MA 02111-1901 | |
| (617) 804-6767 | |
| (877) 726-8492 |
| Full Name | Boston Specialists - South Shore Llc |
|---|---|
| Speciality | Allergy & Immunology |
| Location | 75 Kneeland St Fl 1, Boston, Massachusetts |
| Authorized Official Name and Position | John Leung (OWNER) |
| Authorized Official Contact | 7348464910 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Boston Specialists - South Shore Llc 1 Nassau St Unit 1906 Boston MA 02111-1587 Ph: (617) 804-6767 | Boston Specialists - South Shore Llc 75 Kneeland St Fl 1 Boston MA 02111-1901 Ph: (617) 804-6767 |
| NPI Number | 1730810987 |
|---|---|
| Provider Enumeration Date | 06/20/2022 |
| Last Update Date | 11/08/2023 |
| Medicare PECOS PAC ID | 2860868627 |
|---|---|
| Medicare Enrollment ID | O20221019000945 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1730810987 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RG0100X | Internal Medicine - Gastroenterology | (* (Not Available)) | Secondary |
| 207K00000X | Allergy & Immunology | (* (Not Available)) | Primary |
| Provider Name | John Leung |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1447328711 PECOS PAC ID: 3779585468 Enrollment ID: I20100727000640 |
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