Individual
ROGER BREITBART
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
300 LONGWOOD AVE, BOSTON, MA 02115-5724
(617) 355-6793
Mailing address
PO BOX 845628, BOSTON, MA 02284-5628
(617) 355-6793
Taxonomy
Speciality
Code
Description
License number
State
2080P0202X
Pediatric Cardiology Physician
Primary
53193
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003066653
—
CT
05
—
1098686
—
NY
05
—
30002638
—
NH
05
—
3036791
—
MA
Enumeration date
02/16/2006
Last updated
12/10/2009
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