Individual
DR. BARUCH SOLOMON TICHO
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
MD PHD
Contact information
Practice address
55 FRUIT STREET, VBK 615 PEDIATRIC CARDIOLOGY, BOSTON, MA 02114-2696
(617) 726-3826
(617) 726-2049
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
208000000X
Pediatrics Physician
Primary
75438
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3129675
—
MA
01
—
729867
TUFTS HEALTH PLAN
MA
01
—
J14729
BCBS MA
MA
Enumeration date
06/07/2006
Last updated
07/08/2007
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