1124070008 NPI number — THOMAS A VERDI MD

Table of content: THOMAS A VERDI MD (NPI 1124070008)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1124070008 NPI number — THOMAS A VERDI MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
VERDI
Provider First Name:
THOMAS
Provider Middle Name:
A
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1124070008
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/05/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
133 BROOKLINE AVE
Provider Second Line Business Mailing Address:
RADIOLOGY DEPT
Provider Business Mailing Address City Name:
BOSTON
Provider Business Mailing Address State Name:
MA
Provider Business Mailing Address Postal Code:
02215-3904
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
617-421-1336
Provider Business Mailing Address Fax Number:
617-421-1359

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
133 BROOKLINE AVE
Provider Second Line Business Practice Location Address:
RADIOLOGY DEPT
Provider Business Practice Location Address City Name:
BOSTON
Provider Business Practice Location Address State Name:
MA
Provider Business Practice Location Address Postal Code:
02215-3904
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
617-421-1336
Provider Business Practice Location Address Fax Number:
617-421-1359
Provider Enumeration Date:
05/17/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 2085R0202X , with the licence number:  58675 , registered in the state of MA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 3026272 . This is a "MEDICAID WELFARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: J06727 . This is a "BLUE CARE ELECT" identifier . This identifiers is of the category "OTHER".
  • Identifier: J06727 . This is a "BLUE SHIELD INDEMNITY" identifier . This identifiers is of the category "OTHER".
  • Identifier: J06727 . This is a "BLUE SHIELD HMO BLUE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 042472266 . This is a "ONE HEALTH PLAN" identifier . This identifiers is of the category "OTHER".
  • Identifier: 3026272 , issued by the state of ( MA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 7384295 . This is a "AETNA US HEALTHCARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 784218 . This is a "MVP HEALTH CARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 7996 . This is a "FALLON COMMUNITY HEALTH P" identifier . This identifiers is of the category "OTHER".
  • Identifier: 042472266 . This is a "HEALTHCARE VALUE MANAGEME" identifier . This identifiers is of the category "OTHER".
  • Identifier: 1150385 . This is a "FIRST HEALTH" identifier . This identifiers is of the category "OTHER".
  • Identifier: 1179211 . This is a "CIGNA HEALTH PLAN" identifier . This identifiers is of the category "OTHER".
  • Identifier: J06727 . This is a "MEDICARE B" identifier . This identifiers is of the category "OTHER".
  • Identifier: 27032 . This is a "HEALTHY START" identifier . This identifiers is of the category "OTHER".
  • Identifier: 300081204 . This is a "RAILROAD MEDICARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 042472266 . This is a "PRIVATE HEALTHCARE SYSTEM" identifier . This identifiers is of the category "OTHER".
  • Identifier: 27032 . This is a "CHILDRENS MEDICAL SECURIT" identifier . This identifiers is of the category "OTHER".
  • Identifier: AA2843 . This is a "HARVARD PILGRIM HEALTHCAR" identifier . This identifiers is of the category "OTHER".




Copyright © 2007-2024 www.npivalidator.com