Provider Demographics
NPI:1386602894
Name:GOLDBERG, HILARY J (MD)
Entity type:Individual
Prefix:DR
First Name:HILARY
Middle Name:J
Last Name:GOLDBERG
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:HILARY
Other - Middle Name:J
Other - Last Name:GLASBERG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:75 FRANCIS ST
Mailing Address - Street 2:BWH, PBB CLINICS-3
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02115-6110
Mailing Address - Country:US
Mailing Address - Phone:617-732-7420
Mailing Address - Fax:617-732-7421
Practice Address - Street 1:75 FRANCIS ST
Practice Address - Street 2:BWH, PBB CLINICS-3
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02115-6110
Practice Address - Country:US
Practice Address - Phone:617-732-7420
Practice Address - Fax:617-732-7421
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-03
Last Update Date:2012-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA157751207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA2108631OtherMASSHEALTH
MAAA42892OtherHPHC
494175OtherTUFTS HEALTH PLAN
MAJ29313OtherBCBS
H18699Medicare UPIN