Healthcare Provider Details

I. General information

NPI: 1124778576
Provider Name (Legal Business Name): JAD ELIAS HILAL
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/28/2022
Last Update Date: 05/08/2026
Certification Date: 05/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

75 FRANCIS ST
BOSTON MA
02115-6110
US

IV. Provider business mailing address

246 BROOKLINE ST APT 2
CAMBRIDGE MA
02139-4876
US

V. Phone/Fax

Practice location:
  • Phone: 617-732-5500
  • Fax:
Mailing address:
  • Phone: 412-639-7685
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number1019273
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: