Individual
DR. THADDEUS P. DRYJA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
243 CHARLES ST, BOSTON, MA 02114-3002
(617) 573-3319
Mailing address
PO BOX 8010, BOSTON, MA 02114-0916
(617) 573-4458
(617) 573-4037
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
41891
MA
207ZP0105X
Clinical Pathology/Laboratory Medicine Physician
41891
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0148296
—
MA
Enumeration date
09/01/2005
Last updated
10/08/2010
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