Healthcare Provider Details

I. General information

NPI: 1699907238
Provider Name (Legal Business Name): JESSE ESCH M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/16/2009
Last Update Date: 11/18/2020
Certification Date: 11/18/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 LONGWOOD AVE BADER 2, DEPARTMENT OF CARDIOLOGY
BOSTON MA
02115-5724
US

IV. Provider business mailing address

300 LONGWOOD AVE BADER 2, DEPARTMENT OF CARDIOLOGY
BOSTON MA
02115-5724
US

V. Phone/Fax

Practice location:
  • Phone: 617-355-6529
  • Fax: 617-739-6282
Mailing address:
  • Phone: 617-355-6529
  • Fax: 617-739-6282

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2080P0202X
TaxonomyPediatric Cardiology Physician
License Number248313
License Number StateMA
# 2
Primary TaxonomyY
Taxonomy Code207RI0011X
TaxonomyInterventional Cardiology Physician
License Number248313
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: