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Organization

ALAN BULOTSKY, MD & ASSOCIATES, PC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MARK A. HAUSMAN MD (PRESIDENT)
(508) 584-1890
Entity
Organization

Contact information

Practice address
201 QUINCY ST, BROCKTON, MA 02302-2926
(508) 584-1890
(508) 580-3332
Mailing address
201 QUINCY ST, BROCKTON, MA 02302-2926
(508) 584-1890
(508) 580-3332

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
MA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
20125
HARVARD PILGRIM HEALTH
MA
01
600703
TUFTS HEALTHCARE
MA
05
9769196
MA
01
M15672
BLUE CROSS & BLUE SHIELD
MA
Enumeration date
05/16/2006
Last updated
03/19/2012
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