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Organization

TRUSTEES OF TUFTS COLLEGE

Active
Parent organization
TRUSTEES OF TUFTS COLLEGE
Other names
Tufts Oral Pathology Services
Organization subpart
Yes

Provider details

NPI number
Legal business name
TRUSTEES OF TUFTS COLLEGE
Authorized official
LISA GATELY (CREDENTIALING)
(617) 636-6505
Entity
Organization

Contact information

Practice address
1 KNEELAND ST, DHS-646, BOSTON, MA 02111-1527
(617) 636-6510
(617) 636-6780
Mailing address
1 KNEELAND ST, DHS-646, BOSTON, MA 02111-1527
(617) 636-6510
(617) 636-6780

Taxonomy

Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
110000011O
MA
01
228200
BLUE CROSS BLUE SHIELD
Enumeration date
02/13/2007
Last updated
07/12/2023
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