Individual
DR. MIRIAM ANTOINETTE BREDELLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
55 FRUIT ST, RADIOLOGICAL ASSOCIATES YAW 6, BOSTON, MA 02114-2696
(617) 726-7717
Mailing address
PO BOX 9142, MASS GENERAL PHYSICIAN ORGANIZATION, CHARLESTOWN, MA 02129-9142
(617) 726-7717
(617) 726-5282
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
220247
MA
2085R0202X
Diagnostic Radiology Physician
Primary
326143
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2068940
—
MA
01
—
468985
TUFTS HEALTH PLAN
—
01
—
J27258
BCBS MA
MA
Enumeration date
10/27/2005
Last updated
09/28/2023
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