Individual
DR. RANDIE M BLACK-SCHAFFER
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
125 NASHUA ST, SRH, BOSTON, MA 02114-1101
(617) 573-2770
(617) 573-2769
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
208100000X
Physical Medicine & Rehabilitation Physician
Primary
44943
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
044943
TUFTS HEALTH PLAN
MA
05
—
2098369
—
MA
01
—
B53105
BCBS MS
MA
Enumeration date
11/14/2005
Last updated
07/08/2007
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