Provider Demographics
NPI:1194768531
Name:ROSETO, JAMES P (MD)
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:P
Last Name:ROSETO
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Gender:M
Credentials:MD
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Mailing Address - Street 1:133 BROOKLINE AVE
Mailing Address - Street 2:INTERNAL MEDICINE
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02215
Mailing Address - Country:US
Mailing Address - Phone:617-421-5804
Mailing Address - Fax:617-421-8865
Practice Address - Street 1:133 BROOKLINE AVE
Practice Address - Street 2:INTERNAL MEDICINE 6
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02215-3904
Practice Address - Country:US
Practice Address - Phone:617-421-5804
Practice Address - Fax:617-421-8865
Is Sole Proprietor?:No
Enumeration Date:2006-06-14
Last Update Date:2020-11-17
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Provider Licenses
StateLicense IDTaxonomies
MA223153207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA2108291Medicaid
MAI41645Medicare UPIN
MA2108291Medicaid