Provider Demographics
NPI:1285603001
Name:BURSTEIN, HAROLD JOHN (MD PHD)
Entity type:Individual
Prefix:
First Name:HAROLD
Middle Name:JOHN
Last Name:BURSTEIN
Suffix:
Gender:M
Credentials:MD PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:44 BINNEY ST
Mailing Address - Street 2:DANA FARBER CANCER INSTITUTE
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02115
Mailing Address - Country:US
Mailing Address - Phone:617-632-2624
Mailing Address - Fax:617-632-1930
Practice Address - Street 1:44 BINNEY ST
Practice Address - Street 2:DANA FARBER CANCER INSTITUTE
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02115
Practice Address - Country:US
Practice Address - Phone:617-632-2624
Practice Address - Fax:617-632-1930
Is Sole Proprietor?:No
Enumeration Date:2006-03-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA150929207RX0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RX0202XAllopathic & Osteopathic PhysiciansInternal MedicineMedical Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
14372DFOtherHPHC DFCI ONLY
150929OtherTUFTS
3510008OtherCIGNA
MAJ21025OtherMA BLUE CROSS BLUE SHIELD
J21025OtherHMO BLUE
3600464OtherUNITED HEALTH CARE
900002573OtherRR MEDICARE DFCI
MA3192601Medicaid
J21025OtherINDEMNITY
J21025OtherBC ELECT
2224504OtherAETNA US HEALTHCARE
3192601OtherMASSHEALTH
50537OtherFALLON COMM HEALTH PLAN
MAJ21025OtherMA BLUE CROSS BLUE SHIELD
A29512Medicare ID - Type Unspecified