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1275736050

NPI Code Detail

MEDICARE: DR. OMAR E ETON M.D.

MEDICARE: DR. OMAR E ETON M.D.

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
1	207RH0003X	Hematology & Oncology Physician	166561	NY
2	207RH0003X	Hematology & Oncology Physician	230372	MA
3	207RX0202X	Medical Oncology Physician	G7403	TX
4	207RH0003X	Hematology & Oncology Physician	56793	CT
5	207RX0202X	Medical Oncology Physician	116561	NY
6	207R00000X	Internal Medicine Physician	230372	MA
7	207RX0202X	Medical Oncology Physician	39217	NH

Other Identifiers

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

General Provider Information

NPI Number	:	1275736050
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. OMAR E ETON M.D.

Provider Business Mailing Address
First Line	:	34 LARCHWOOD DR
Second Line	:
City	:	CAMBRIDGE
State	:	MA
Zip	:	02138-4606
Country	:	US
Telephone Number	:	617-955-0100
Fax Number	:

Provider Business Practice Location Address
First Line	:	327 BEACH 19TH ST
Second Line	:
City	:	FAR ROCKAWAY
State	:	NY
Zip	:	11691-4423
Country	:	US
Telephone Number	:	718-869-7000
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/07/2007
Last Update Date	:	04/28/2026

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Directions to “ DR. OMAR E ETON M.D.” Practice Location

Language	Start Address	Practice Location

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