Individual
DR. RICHARD ERIC MIZNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
55 FRUIT ST, PEDIATRIC GROUP PRACTICE YAW 6, BOSTON, MA 02114-2621
(617) 726-2728
(617) 724-3948
Mailing address
PO BOX 9142, MASS GENERAL PHYSICIAN ORGANIZATION, CHARLESTOWN, MA 02129-9142
(617) 726-2728
(617) 724-3948
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
81000
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
087000
TUFTS HEALTH PLAN
MA
05
—
3138046
—
MA
01
—
J31195
BCBS MA
MA
Enumeration date
10/24/2005
Last updated
07/31/2012
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