Provider Demographics
NPI:1346217932
Name:GEORGE, RANI E (MD PHD)
Entity type:Individual
Prefix:
First Name:RANI
Middle Name:E
Last Name:GEORGE
Suffix:
Gender:F
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 1:450 BROOKLINE AVE
Mailing Address - Street 2:DANA 322 DEPT OF PEDIATRIC ONCOLOGY
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02215-5418
Mailing Address - Country:US
Mailing Address - Phone:617-632-5281
Mailing Address - Fax:617-632-4850
Practice Address - Street 1:450 BROOKLINE AVE
Practice Address - Street 2:DANA 322 DEPT OF PEDIATRIC ONCOLOGY
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02215-5418
Practice Address - Country:US
Practice Address - Phone:617-632-5281
Practice Address - Fax:617-632-4850
Is Sole Proprietor?:No
Enumeration Date:2006-03-02
Last Update Date:2012-03-14
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA2136412080P0207X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0207XAllopathic & Osteopathic PhysiciansPediatricsPediatric Hematology-Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
6090604OtherCIGNA
AA19323OtherHPHC DFCI ONLY
J27355OtherMA BCBS
2040310OtherMASSHEALTH MA MEDICAID
213641OtherTUFTS
AA19323OtherHPHC DFCI ONLY
J27355OtherMA BCBS