1528036902 NPI number — EDMUND SAULIUS CIBAS MD

Table of content: RYLEE T ROL (NPI 1023837127)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1528036902 NPI number — EDMUND SAULIUS CIBAS MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
CIBAS
Provider First Name:
EDMUND
Provider Middle Name:
SAULIUS
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:
1528036902
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/13/2026
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
75 FRANCIS ST
Provider Second Line Business Mailing Address:
BRIGHAM AND WOMENS HOSPITAL DEPT OF PATHOLOGY
Provider Business Mailing Address City Name:
BOSTON
Provider Business Mailing Address State Name:
MA
Provider Business Mailing Address Postal Code:
02115
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
617-732-6797
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
75 FRANCIS ST
Provider Second Line Business Practice Location Address:
BRIGHAM AND WOMENS HOSPITAL DEPT OF PATHOLOGY
Provider Business Practice Location Address City Name:
BOSTON
Provider Business Practice Location Address State Name:
MA
Provider Business Practice Location Address Postal Code:
02115
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
617-732-6797
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
03/10/2006

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: 207ZP0101X , with the licence number:  54212 , 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: 730580 . This is a "TUFTS PROVIDER NUMBER" identifier . This identifiers is of the category "OTHER".
  • Identifier: 2382808 . This is a "AETNA US HEALTH #" identifier . This identifiers is of the category "OTHER".
  • Identifier: 07220029912 . This is a "RRM GROUP SPECIFIC PROVID" identifier . This identifiers is of the category "OTHER".
  • Identifier: 07A59029BWHT . This is a "HARVARD PILGRIM HEALTH CA" identifier . This identifiers is of the category "OTHER".
  • Identifier: J06277 . This is a "BLUE SHIELD ID #" identifier . This identifiers is of the category "OTHER".
  • Identifier: 1100036 . This is a "UHC NUMBER" identifier . This identifiers is of the category "OTHER".
  • Identifier: 6419602 . This is a "CIGNA NUMBER" identifier . This identifiers is of the category "OTHER".




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