Individual
JEROME AUERBACH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
133 BROOKLINE AVE, BOSTON, MA 02215-3904
(617) 421-1000
Mailing address
133 BROOKLINE AVE, BOSTON, MA 02215-3904
(617) 421-1000
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
44121
MA
2085R0202X
Diagnostic Radiology Physician
117208
NY
2085R0202X
Diagnostic Radiology Physician
Primary
44121
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00579915
—
NY
05
—
2070154
—
MA
01
—
677T91
MEDICARE
NY
Enumeration date
09/19/2005
Last updated
09/24/2013
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