Provider Demographics
NPI:1063805687
Name:TUFTS MEDICAL CENTER COMMUNITY CARE, INC
Entity type:Organization
Organization Name:TUFTS MEDICAL CENTER COMMUNITY CARE, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:NATHAN
Authorized Official - Middle Name:J
Authorized Official - Last Name:GAGNE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:781-356-3336
Mailing Address - Street 1:325 WOOD RD
Mailing Address - Street 2:SUITE 210
Mailing Address - City:BRAINTREE
Mailing Address - State:MA
Mailing Address - Zip Code:02184-2413
Mailing Address - Country:US
Mailing Address - Phone:781-356-3336
Mailing Address - Fax:
Practice Address - Street 1:325 WOOD RD
Practice Address - Street 2:SUITE 210
Practice Address - City:BRAINTREE
Practice Address - State:MA
Practice Address - Zip Code:02184-2413
Practice Address - Country:US
Practice Address - Phone:781-356-3336
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:TUFTS MEDICAL CENTER PARENT, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2015-03-06
Last Update Date:2020-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Multi-Specialty