Healthcare Provider Details

I. General information

NPI: 1639033988
Provider Name (Legal Business Name): BOSTON PUBLIC HEALTH COMMISSION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/11/2025
Last Update Date: 12/11/2025
Certification Date: 12/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1010 MASSACHUSETTS AVE
BOSTON MA
02118-2600
US

IV. Provider business mailing address

1010 MASSACHUSETTS AVE
BOSTON MA
02118-2600
US

V. Phone/Fax

Practice location:
  • Phone: 617-534-5395
  • Fax:
Mailing address:
  • Phone: 617-534-5395
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: JUDITH MARTINEZ
Title or Position: DIRECTOR OF REVENUE
Credential:
Phone: 617-534-4222