Healthcare Provider Details

I. General information

NPI: 1528046257
Provider Name (Legal Business Name): KONSTANTINOS PAPADAKIS M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/03/2006
Last Update Date: 01/16/2025
Certification Date: 01/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 LONGWOOD AVE CHILDREN'S HOSPITAL BOSTON, FEGAN BLDG. 3RD FLOOR
BOSTON MA
02115
US

IV. Provider business mailing address

300 LONGWOOD AVE CHILDREN'S HOSPITAL BOSTON, FEGAN BLDG. 3RD FLOOR
BOSTON MA
02115
US

V. Phone/Fax

Practice location:
  • Phone: 617-355-6915
  • Fax: 617-730-0477
Mailing address:
  • Phone: 617-355-6915
  • Fax: 617-730-0477

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number159767
License Number StateMA
# 2
Primary TaxonomyY
Taxonomy Code2086S0120X
TaxonomyPediatric Surgery Physician
License Number159767
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: