Organization
FAULKNER COMMUNITY MEDICAL CORP
Active
Organization
FAULKNER COMMUNITY MEDICAL CORP
Active
Other names
Hyde Park Medical Care
Organization subpart
No
Provider details
NPI number
Authorized official
JULIANA J KELEHER RN (MANAGER)
(617) 364-9880
Entity
Organization
Contact information
Practice address
1337 HYDE PARK AVE, HYDE PARK, MA 02136-2713
(617) 364-9880
(617) 361-3663
Mailing address
1337 HYDE PARK AVE, HYDE PARK, MA 02136-2713
(617) 364-9880
(617) 361-3663
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000029506
BOSTON HEALTH NET
—
01
—
0006838
NEIGHBORHOOD HEALTH PLAN
—
01
—
44442
AETNA US HEALTHCARE
—
01
—
610235
TUFTS
MA
05
—
9779434
—
MA
01
—
CG3305
PALMETTO GBA RAILROAD MED
—
01
—
FAM16477
BXBS
MA
Enumeration date
09/15/2005
Last updated
08/22/2020
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