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General NPI Number Information
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NPI Number | 1679158703
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Entity Type | Organization
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Legal Business Name | NEW PATH MEDICAL LLC
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Dates
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Enumeration Date | 03/10/2021
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Last Update Date | 03/10/2021
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Provider Practice Location Address
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Address Line | 25 BAY STATE RD APT 5
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City | BOSTON
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State | MA
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Zip | 02215-2108
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Country | US
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Telephone | 617-286-6518
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Fax |
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Provider Business Mailing Address
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Address Line | 25 BAY STATE RD APT 5
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City | BOSTON
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State | MA
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Zip | 02215-2108
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Country | US
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Telephone | 617-286-6518
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | MR. JASON CARDINAL
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Credential |
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Telephone | 713-298-5197
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RX0202X
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Taxonomy Name | Medical Oncology Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207RH0003X
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Taxonomy Name | Hematology & Oncology Physician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 261QX0200X
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Taxonomy Name | Oncology Clinic/Center
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License Number |
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License Number State |
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