MEDICARE: DR. JULIO JOSE HAJDENBERG MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RH0003X	Hematology & Oncology Physician	MD29753	ME
2	207RH0003X	Hematology & Oncology Physician	79524	MA
3	207RH0003X	Hematology & Oncology Physician	ME73222	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1255315958
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JULIO JOSE HAJDENBERG MD

Provider Business Mailing Address
First Line	:	PO BOX 24520
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10087-3720
Country	:	US
Telephone Number	:	781-744-8085
Fax Number	:

Provider Business Practice Location Address
First Line	:	JAMAICA PLAIN VA MEDICAL CENTER/HEMATOLOGY-ONCOLOGY
Second Line	:	130 S. HUNTINGTON AVE.
City	:	BOSTON
State	:	MA
Zip	:	02130
Country	:	US
Telephone Number	:	617-232-9500
Fax Number	:	407-425-5203

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/06/2005
Last Update Date	:	01/07/2026

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