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NPI Code Detail

MEDICARE: MILTON RADIOLOGISTS INC

MEDICARE: MILTON RADIOLOGISTS INC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
12085R0202XDiagnostic Radiology PhysicianMA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2M13416OTHERMABCBS MA

General Provider Information

NPI Number : 1275510018
Entity Type Code : Organization
Provider Name (Legal Business Name) : MILTON RADIOLOGISTS INC
Provider Business Mailing Address
First Line : PO BOX 9132
Second Line :
City : BROOKLINE
State : MA
Zip : 02446-9132
Country : US
Telephone Number : 800-927-0002
Fax Number : 603-893-8886
Provider Business Practice Location Address
First Line : 199 REEDSDALE AVE
Second Line :
City : MILTON
State : MA
Zip : 02186-3926
Country : US
Telephone Number : 617-696-4600
Fax Number :
Authorized Official
Title or Position : PRESIDENT
Name : MR. MARK LIPSKY
Credential : MD
Telephone Number : 617-313-1140
Provider Enumeration Date : 12/22/2005
Last Update Date : 01/29/2015

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