Organization
PRATT MEDICAL GROUP, INC
Active
Parent organization
PRATT MEDICAL GROUP, INC
Other names
Pratt Medical Group, Inc. - Palliative Care
Organization subpart
Yes
Provider details
NPI number
Legal business name
PRATT MEDICAL GROUP, INC
Authorized official
EDWARD ROBERT GALLEGOS (DIRECTOR)
(701) 610-0553
Entity
Organization
Contact information
Practice address
800 WASHINGTON ST, BOSTON, MA 02111-1552
(617) 636-5000
(617) 636-7060
Mailing address
800 WASHINGTON ST, BOSTON, MA 02111-1552
(617) 636-5000
(617) 636-7060
Taxonomy
Speciality
Code
Description
License number
State
207QH0002X
Hospice and Palliative Medicine (Family Medicine) Physician
Primary
—
—
2080H0002X
Pediatric Hospice and Palliative Medicine Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
042748394
IRS
MA
Enumeration date
12/05/2017
Last updated
06/16/2018
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