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General NPI Number Information
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NPI Number | 1174723407
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Entity Type | Individual
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Provider Name | JOHN RAHUL TEDROW MD
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Gender | Male
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Dates
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Enumeration Date | 07/24/2007
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Last Update Date | 11/28/2025
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Provider Practice Location Address
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Address Line | 77 WARREN ST 2ND FLOOR
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City | BRIGHTON
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State | MA
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Zip | 02135-3601
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Country | US
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Telephone | 617-789-2545
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Fax | 617-789-2893
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Provider Business Mailing Address
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Address Line | 77 WARREN ST FL 4
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City | BRIGHTON
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State | MA
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Zip | 02135-3601
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Country | US
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Telephone | 617-789-2545
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Fax | 617-789-2893
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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 | 207RP1001X
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Taxonomy Name | Pulmonary Disease Physician
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License Number | 269302
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License Number State | MA
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Taxonomy #2
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Taxonomy Code | 207RC0200X
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Taxonomy Name | Critical Care Medicine (Internal Medicine) Physician
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License Number | 01098257A
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License Number State | IN
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