| Online Care Network Ii Pc | |
|
75 State St Fl 26 Boston MA 02109-1827 | |
| (617) 204-3500 | |
| Not Available |
| Full Name | Online Care Network Ii Pc |
|---|---|
| Speciality | General Practice |
| Location | 75 State St Fl 26, Boston, Massachusetts |
| Authorized Official Name and Position | Cynthia Horner (PRESIDENT) |
| Authorized Official Contact | 6172043500 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Online Care Network Ii Pc 75 State St Fl 26 Boston MA 02109-1827 Ph: () - | Online Care Network Ii Pc 75 State St Fl 26 Boston MA 02109-1827 Ph: (617) 204-3500 |
| NPI Number | 1336582550 |
|---|---|
| Provider Enumeration Date | 04/08/2013 |
| Last Update Date | 11/17/2021 |
| Medicare PECOS PAC ID | 4486063781 |
|---|---|
| Medicare Enrollment ID | O20210517000711 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1336582550 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | (* (Not Available)) | Primary |
| Provider Name | Shawn D Mattison |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1972881340 PECOS PAC ID: 7517119712 Enrollment ID: I20121217000204 |
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