Organization
COOLIDGE CORNER IMAGING, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JEAN PIERCE (OFFICE MANAGER)
(617) 661-1949
Entity
Organization
Contact information
Practice address
356 HARVARD ST, BROOKLINE, MA 02446-2905
(617) 383-6585
(617) 383-6592
Mailing address
PO BOX 381289, 31 SMITH PLACE, CAMBRIDGE, MA 02238-1289
(617) 661-1949
(617) 661-1943
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
831660
TUFTS
MA
05
—
9750240
—
MA
01
—
M18932
BLUE CROSS BLUE SHIELD
MA
Enumeration date
01/22/2007
Last updated
12/07/2010
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