MEDICARE: THOMAS CADOGAN

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	2471V0106X	Vascular-Interventional Technology Radiologic Technologist	16268	MA

General Provider Information

NPI Number	:	1659733319
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	THOMAS CADOGAN

Provider Business Mailing Address
First Line	:	96 RUSSELL ST
Second Line	:
City	:	QUINCY
State	:	MA
Zip	:	02171-1651
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	96 RUSSELL ST
Second Line	:
City	:	QUINCY
State	:	MA
Zip	:	02171-1651
Country	:	US
Telephone Number	:	781-854-8178
Fax Number	:

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

Provider Enumeration Date	:	03/22/2016
Last Update Date	:	03/22/2016

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Directions to “ THOMAS CADOGAN ” Practice Location

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