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NPI Code Detail

MEDICARE: JORGE E TELLO MD PC

MEDICARE: JORGE E TELLO MD PC
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
1174400000XSpecialist

General Provider Information

NPI Number : 1336557958
Entity Type Code : Organization
Provider Name (Legal Business Name) : JORGE E TELLO MD PC
Provider Business Mailing Address
First Line : 21 SCHOOL ST
Second Line : STE 1
City : QUINCY
State : MA
Zip : 02169-6640
Country : US
Telephone Number : 617-302-3343
Fax Number : 617-481-4655
Provider Business Practice Location Address
First Line : 21 SCHOOL ST
Second Line : STE 1
City : QUINCY
State : MA
Zip : 02169-6640
Country : US
Telephone Number : 617-302-3343
Fax Number : 617-481-4655
Authorized Official
Title or Position : PRESIDENT
Name : JORGE E. TELLO
Credential : MD
Telephone Number : 617-302-3343
Provider Enumeration Date : 07/28/2014
Last Update Date : 07/28/2014

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Directions to “JORGE E TELLO MD PC ” Practice Location

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