Individual
DR. JEFFREY D MACKLIS
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
15 PARKMAN STREET, NEUROLOGY ASSOCIATES WAC 835, BOSTON, MA 02114-3117
(617) 726-8581
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
2084N0400X
Neurology Physician
Primary
58788
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
304063I
—
MA
01
—
730069
TUFTS HEALTH PLAN
MA
01
—
J08200
BCBS MA
MA
Enumeration date
06/07/2006
Last updated
07/08/2007
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