Provider Demographics
NPI:1194716738
Name:KASMAR, ANNE GAELYN (MD)
Entity type:Individual
Prefix:DR
First Name:ANNE
Middle Name:GAELYN
Last Name:KASMAR
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:PO BOX 9142
Mailing Address - Street 2:MASS GENERAL PHYSICIAN ORGANIZATION
Mailing Address - City:CHARLESTOWN
Mailing Address - State:MA
Mailing Address - Zip Code:02129-9142
Mailing Address - Country:US
Mailing Address - Phone:617-726-3906
Mailing Address - Fax:617-726-7653
Practice Address - Street 1:55 FRUIT ST
Practice Address - Street 2:GRB 504
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02114-2621
Practice Address - Country:US
Practice Address - Phone:617-726-3906
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-11-02
Last Update Date:2013-02-12
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA218391207R00000X, 207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA206559OtherTUFTS HEALTH PLAN
MA2012341Medicaid
MAJ26339OtherBCBS MA
MA2012341Medicaid
MAA35622Medicare ID - Type Unspecified