Healthcare Provider Details

I. General information

NPI: 1033173612
Provider Name (Legal Business Name): ANDREW L TERRONO M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 04/12/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

125 PARKER HILL AVENUE
BOSTON MA
02120
US

IV. Provider business mailing address

125 PARKER HILL AVENUE
BOSTON MA
02120
US

V. Phone/Fax

Practice location:
  • Phone: 617-738-0857
  • Fax: 617-731-3109
Mailing address:
  • Phone: 617-738-0857
  • Fax: 617-731-3109

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2086S0105X
TaxonomySurgery of the Hand (Surgery) Physician
License Number52245
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: