Provider Demographics
NPI:1225028137
Name:BLASZKOWSKY, LAWRENCE SCOTT (MD)
Entity type:Individual
Prefix:DR
First Name:LAWRENCE
Middle Name:SCOTT
Last Name:BLASZKOWSKY
Suffix:
Gender:M
Credentials:MD
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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:617-724-1700
Mailing Address - Fax:617-724-3166
Practice Address - Street 1:55 FRUIT ST
Practice Address - Street 2:HEMATOLOGY/ONCOLOGY
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02114-2621
Practice Address - Country:US
Practice Address - Phone:617-724-1700
Practice Address - Fax:617-724-3166
Is Sole Proprietor?:No
Enumeration Date:2005-10-24
Last Update Date:2012-10-15
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Provider Licenses
StateLicense IDTaxonomies
MA80772207RH0000X, 207RX0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RX0202XAllopathic & Osteopathic PhysiciansInternal MedicineMedical Oncology
No207RH0000XAllopathic & Osteopathic PhysiciansInternal MedicineHematology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA3153151Medicaid
MAJ16683OtherBCBS MA
MA080772OtherTUFTS HEALTH PLAN
MAA21445Medicare ID - Type Unspecified
G30461Medicare UPIN