Individual
JORGE ENRIQUE TELLO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
630 ADAMS ST, MILTON, MA 02186-5631
(617) 698-0910
(617) 696-3722
Mailing address
2110 DORCHESTER AVE, SUITE 302, DORCHESTER, MA 02124-5699
(617) 698-0910
(617) 696-3722
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
38537
MA
207RX0202X
Medical Oncology Physician
38537
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
038537
TUFTS HEALTH PLAN
MA
05
—
2039052
—
MA
01
—
6359
HARVARD PILGRIM HC
MA
01
—
TEM09072
BLUE CROSS BLUE SHIELD MA
MA
Enumeration date
07/31/2006
Last updated
06/12/2008
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