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General NPI Number Information
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NPI Number | 1265714091
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Entity Type | Organization
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Legal Business Name | FOUNDATION MEDICINE, INC.
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Dates
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Enumeration Date | 09/19/2011
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Last Update Date | 09/23/2025
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Provider Practice Location Address
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Address Line | 150 2ND ST
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City | CAMBRIDGE
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State | MA
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Zip | 02141-2115
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Country | US
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Telephone | 617-418-2200
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Fax |
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Provider Business Mailing Address
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Address Line | 400 SUMMER ST
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City | BOSTON
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State | MA
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Zip | 02210-1717
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Country | US
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Telephone | 617-418-2200
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Fax |
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Authorized Official
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Title or Position | DIRECTOR, REVENUE AND REIMBURSEMENT
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Name | MS. BAHAREH GURLEY
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Credential |
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Telephone | 781-707-6322
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 291U00000X
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Taxonomy Name | Clinical Medical Laboratory
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License Number | 22D2027531
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License Number State | MA
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