Healthcare Provider Details

I. General information

NPI: 1285619155
Provider Name (Legal Business Name): HERBERT BOERSTLING M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 12/13/2005
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

333 LONGWOOD AVE CHILDREN'S HOSPITAL
BOSTON MA
02115-5711
US

IV. Provider business mailing address

147 MILK ST PROVIDER ENROLLMENT - 9TH FLOOR
BOSTON MA
02109-4806
US

V. Phone/Fax

Practice location:
  • Phone: 617-355-8732
  • Fax: 617-277-8934
Mailing address:
  • Phone: 617-559-8053
  • Fax: 617-421-3487

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number31636
License Number StateMA
# 2
Primary TaxonomyY
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number31636
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: