Individual
DR. THADDEUS W HERLICZEK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
300 LONGWOOD AVE, BOSTON, MA 02115-5724
(617) 355-6000
Mailing address
300 LONGWOOD AVE, BOSTON, MA 02115-5724
(617) 355-6000
Taxonomy
Speciality
Code
Description
License number
State
2085P0229X
Pediatric Radiology Physician
Primary
231919
MA
2085P0229X
Pediatric Radiology Physician
MD500003109
DC
2085R0202X
Diagnostic Radiology Physician
12603
RI
2085R0202X
Diagnostic Radiology Physician
MD70086097
WA
Other
Enumeration date
01/30/2007
Last updated
02/04/2026
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