Organization
CENTER FOR BLISTERING DISEASES, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ABDUL RAZZAQUE AHMED MD (PRESIDENT)
(617) 562-1040
Entity
Organization
Contact information
Practice address
697 CAMBRIDGE ST, SUITE 302, BOSTON, MA 02135-2897
(617) 562-1040
(617) 562-1047
Mailing address
697 CAMBRIDGE ST, SUITE 302, BOSTON, MA 02135-2897
(617) 562-1040
(617) 562-1047
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
001620
NEIGHBORHOOD HEALTH
—
01
—
3051578
AETNA US HEALTHCARE
—
01
—
59699
FALLON HEALTH PLAN
—
01
—
690849
TUFTS SECURE HORIZONS
—
01
—
CQ80
HARVARD PILGRIM HEALTH
—
01
—
DA7122
RAILROAD MEDICARE PALMETO
—
01
—
M17819
BCBS RI
—
Enumeration date
11/08/2006
Last updated
11/10/2016
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