Provider Demographics
NPI:1316916372
Name:MILUNSKY, JEFF MARK (MD)
Entity type:Individual
Prefix:DR
First Name:JEFF
Middle Name:MARK
Last Name:MILUNSKY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:840 MEMORIAL DR
Mailing Address - Street 2:SUITE 101
Mailing Address - City:CAMBRIDGE
Mailing Address - State:MA
Mailing Address - Zip Code:02139-3789
Mailing Address - Country:US
Mailing Address - Phone:617-492-7083
Mailing Address - Fax:617-492-7092
Practice Address - Street 1:840 MEMORIAL DR
Practice Address - Street 2:SUITE 101
Practice Address - City:CAMBRIDGE
Practice Address - State:MA
Practice Address - Zip Code:02139-3789
Practice Address - Country:US
Practice Address - Phone:617-492-7083
Practice Address - Fax:617-492-7092
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-14
Last Update Date:2012-11-07
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MA80918207SG0201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207SG0201XAllopathic & Osteopathic PhysiciansMedical GeneticsClinical Genetics (M.D.)
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA3146502Medicaid
J31448Medicare UPIN
MA3146502Medicaid