Individual
DR. JULES LEONARD DIENSTAG
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
55 FRUIT ST, BLK 4, GASTROENTEROLOGY ASSOCIATES, BOSTON, MA 02114-2696
(617) 726-7450
(617) 726-3673
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
207R00000X
Internal Medicine Physician
Primary
42401
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
042401
TUFTS HEALTH PLAN
MA
05
—
2062798
—
MA
01
—
M09697
BCBS MA
MA
Enumeration date
02/07/2006
Last updated
07/08/2007
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