Organization
CHILD HEALTH FOUNDATION OF BOSTON
Active
Other names
NUTRITION AND FITNESS FOR LIFE PROGRAM
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DAVID C DIFIORE (DIRECTOR OF FINANCE AND CLINICAL SE)
(617) 414-5509
Entity
Organization
Contact information
Practice address
850 HARRISON AVE, ACC5, BOSTON, MA 02118-4001
(617) 414-5170
Mailing address
1 BOSTON MEDICAL CTR PL, SUITE 317, BOSTON, MA 02118-2908
(617) 414-5170
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0006747
NEIGHBORHOOD HEALTH PLAN
MA
Enumeration date
05/01/2008
Last updated
05/01/2008
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