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NPI Code Detail

MEDICARE: BRUCE A BORNSTEIN M.D.

MEDICARE: BRUCE A BORNSTEIN M.D.
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
12085R0001XRadiation Oncology Physician52961MA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
10712786OTHERMACIGNA
2AA12876OTHERMAHARVARD PILGRIM
3052961OTHERMATUFTS
4MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1770581308
Entity Type Code : Individual
Provider Name (Legal Business Name) : BRUCE A BORNSTEIN M.D.
Provider Business Mailing Address
First Line : PO BOX 415348
Second Line :
City : BOSTON
State : MA
Zip : 02241-5348
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 275 NICHOLS RD
Second Line :
City : FITCHBURG
State : MA
Zip : 01420-1919
Country : US
Telephone Number : 978-343-5196
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/08/2005
Last Update Date : 02/29/2016

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Directions to “ BRUCE A BORNSTEIN M.D.” Practice Location

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