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General NPI Number Information
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NPI Number | 1144329574
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Entity Type | Individual
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Provider Name | CARLOS G TUN M.D.
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Gender | Male
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Dates
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Enumeration Date | 09/22/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 1400 VFW PKWY
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City | WEST ROXBURY
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State | MA
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Zip | 02132-4927
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Country | US
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Telephone | 857-203-6835
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Fax | 857-203-5680
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Provider Business Mailing Address
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Address Line | 48 BERNARD ST
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City | NEWTON
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State | MA
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Zip | 02461-1904
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Country | US
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Telephone | 617-969-5918
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number | 60087
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License Number State | MA
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