Individual
DR. JOHN PATRICK T CO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
300 OCEAN AVENUE RCH, REVERE HEALTHCARE CENTER, REVERE, MA 02151-3675
(781) 485-6024
(781) 485-6391
Mailing address
PO BOX 9142, MASS GENERAL PHYSICIAN ORGANIZATION, CHARLESTOWN, MA 02129-9142
(617) 724-0287
(617) 726-2894
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
160256
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
160256
TUFTS HEALTH PLAN
MA
05
—
3201325
—
MA
01
—
J21625
BCBS MA
MA
Enumeration date
10/31/2005
Last updated
12/20/2012
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