1437134806 NPI number — CELA DOPPELT MD

Table of content: CELA DOPPELT MD (NPI 1437134806)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1437134806 NPI number — CELA DOPPELT MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
DOPPELT
Provider First Name:
CELA
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
F

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:
1437134806
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2000 WASHINGTON ST
Provider Second Line Business Mailing Address:
SUITE 764
Provider Business Mailing Address City Name:
NEWTON
Provider Business Mailing Address State Name:
MA
Provider Business Mailing Address Postal Code:
02462-1628
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
617-965-7800
Provider Business Mailing Address Fax Number:
617-965-4581

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2000 WASHINGTON ST
Provider Second Line Business Practice Location Address:
SUITE 764
Provider Business Practice Location Address City Name:
NEWTON
Provider Business Practice Location Address State Name:
MA
Provider Business Practice Location Address Postal Code:
02462-1628
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
617-965-7800
Provider Business Practice Location Address Fax Number:
617-965-4581
Provider Enumeration Date:
12/08/2005

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: 207VG0400X , with the licence number:  57971 , 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: 13339 . This is a "HPHC" identifier . This identifiers is of the category "OTHER".
  • Identifier: 2257771 . This is a "AETNA US HEALTHCARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 3024326Q , issued by the state of ( MA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 36205 . This is a "HEALTHY START" identifier . This identifiers is of the category "OTHER".
  • Identifier: S023506 . This is a "CHAMPUS" identifier . This identifiers is of the category "OTHER".
  • Identifier: 0017073 . This is a "NEIGHBORHOOD HEALTH" identifier . This identifiers is of the category "OTHER".
  • Identifier: 043200332 . This is a "STANDARD TAX ID" identifier . This identifiers is of the category "OTHER".
  • Identifier: 0700836 . This is a "UNITED HEALTHCARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 710397 . This is a "TUFTS" identifier . This identifiers is of the category "OTHER".
  • Identifier: 164345 . This is a "HEALTHSOURCE MA" identifier . This identifiers is of the category "OTHER".
  • Identifier: B20232801 . This is a "CIGNA" identifier . This identifiers is of the category "OTHER".
  • Identifier: J06539 . This is a "BCBS" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 160057189 . This is a "RAILROAD MEDICARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 710397 . This is a "TUFTS HEALTH PLAN" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".




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