MEDICARE: BOSTON PAIN SOLUTIONS PC

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	207LP2900X	Pain Medicine (Anesthesiology) Physician

General Provider Information

NPI Number	:	1629828587
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BOSTON PAIN SOLUTIONS PC

Provider Business Mailing Address
First Line	:	29 SANDERSON RD
Second Line	:
City	:	LEXINGTON
State	:	MA
Zip	:	02420-2618
Country	:	US
Telephone Number	:	617-894-1506
Fax Number	:

Provider Business Practice Location Address
First Line	:	29 SANDERSON RD
Second Line	:
City	:	LEXINGTON
State	:	MA
Zip	:	02420-2618
Country	:	US
Telephone Number	:	617-894-1506
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	FREDERIC GERGES
Credential	:	MD
Telephone Number	:	617-894-1506

Provider Enumeration Date	:	03/25/2024
Last Update Date	:	03/25/2024

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Directions to “BOSTON PAIN SOLUTIONS PC ” Practice Location

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