Provider Demographics
NPI:1073593810
Name:PALEFSKI, PAUL (MD)
Entity type:Individual
Prefix:
First Name:PAUL
Middle Name:
Last Name:PALEFSKI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1153 CENTRE ST
Mailing Address - Street 2:RADIOLOGY FAULKNER HOSPITAL
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02130
Mailing Address - Country:US
Mailing Address - Phone:617-983-7172
Mailing Address - Fax:617-983-7855
Practice Address - Street 1:1153 CENTRE ST
Practice Address - Street 2:RADIOLOGY FAULKNER HOSPITAL
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02130
Practice Address - Country:US
Practice Address - Phone:617-983-7172
Practice Address - Fax:617-983-7855
Is Sole Proprietor?:No
Enumeration Date:2006-01-18
Last Update Date:2012-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA379832085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA737853OtherTUFTS
MA2037432Medicaid
MAB39144OtherBLUE CROSS BLUE SHIELD
MA2037432Medicaid
MAB39144OtherBLUE CROSS BLUE SHIELD