MEDICARE: NEW PATH MEDICAL LLC

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	207RX0202X	Medical Oncology Physician
2	207RH0003X	Hematology & Oncology Physician
3	261QX0200X	Oncology Clinic/Center

General Provider Information

NPI Number	:	1679158703
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NEW PATH MEDICAL LLC

Provider Business Mailing Address
First Line	:	25 BAY STATE RD APT 5
Second Line	:
City	:	BOSTON
State	:	MA
Zip	:	02215-2108
Country	:	US
Telephone Number	:	617-286-6518
Fax Number	:

Provider Business Practice Location Address
First Line	:	25 BAY STATE RD APT 5
Second Line	:
City	:	BOSTON
State	:	MA
Zip	:	02215-2108
Country	:	US
Telephone Number	:	617-286-6518
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	MR. JASON CARDINAL
Credential	:
Telephone Number	:	713-298-5197

Provider Enumeration Date	:	03/10/2021
Last Update Date	:	03/10/2021

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Directions to “NEW PATH MEDICAL LLC ” Practice Location

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