Healthcare Provider Details

I. General information

NPI: 1346217932
Provider Name (Legal Business Name): RANI E GEORGE MD PHD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/02/2006
Last Update Date: 03/14/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

450 BROOKLINE AVE DANA 322 DEPT OF PEDIATRIC ONCOLOGY
BOSTON MA
02215-5418
US

IV. Provider business mailing address

450 BROOKLINE AVE DANA 322 DEPT OF PEDIATRIC ONCOLOGY
BOSTON MA
02215-5418
US

V. Phone/Fax

Practice location:
  • Phone: 617-632-5281
  • Fax: 617-632-4850
Mailing address:
  • Phone: 617-632-5281
  • Fax: 617-632-4850

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080P0207X
TaxonomyPediatric Hematology & Oncology Physician
License Number213641
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: