Healthcare Provider Details

I. General information

NPI: 1558659482
Provider Name (Legal Business Name): JENNIFER M LUZ M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/12/2011
Last Update Date: 03/17/2025
Certification Date: 03/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

736 CAMBRIDGE ST
BOSTON MA
02135-2907
US

IV. Provider business mailing address

736 CAMBRIDGE ST BONE & JOINT CENTER, 9TH FL
BOSTON MA
02135-2907
US

V. Phone/Fax

Practice location:
  • Phone: 617-789-3000
  • Fax:
Mailing address:
  • Phone: 617-779-6500
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2081S0010X
TaxonomySports Medicine (Physical Medicine & Rehabilitation) Physician
License Number263013
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: