Provider Demographics
NPI:1528472644
Name:ALBIN, JOHN S (MD, PHD)
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:S
Last Name:ALBIN
Suffix:
Gender:M
Credentials:MD, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:55 FRUIT STREET
Mailing Address - Street 2:GRAY-JACKSON 504
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02114
Mailing Address - Country:US
Mailing Address - Phone:617-726-3812
Mailing Address - Fax:617-726-7416
Practice Address - Street 1:55 FRUIT STREET
Practice Address - Street 2:GRAY-JACKSON 504
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02114
Practice Address - Country:US
Practice Address - Phone:617-726-3812
Practice Address - Fax:617-726-7416
Is Sole Proprietor?:No
Enumeration Date:2014-06-17
Last Update Date:2019-04-30
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA269392207RI0200X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine