Provider Demographics
NPI:1992122295
Name:BOSTON MEDICAL, P.C.
Entity type:Organization
Organization Name:BOSTON MEDICAL, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:MARIANNE
Authorized Official - Middle Name:C
Authorized Official - Last Name:LABARBERA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:718-981-4070
Mailing Address - Street 1:990 STEWART STREET
Mailing Address - Street 2:SUITE 230
Mailing Address - City:GARDEN CITY
Mailing Address - State:NY
Mailing Address - Zip Code:11530
Mailing Address - Country:US
Mailing Address - Phone:516-222-7080
Mailing Address - Fax:516-222-7927
Practice Address - Street 1:990 STEWART STREET
Practice Address - Street 2:SUITE 230
Practice Address - City:GARDEN CITY
Practice Address - State:NY
Practice Address - Zip Code:11530
Practice Address - Country:US
Practice Address - Phone:516-222-7080
Practice Address - Fax:516-222-7927
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-03-25
Last Update Date:2014-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208800000XAllopathic & Osteopathic PhysiciansUrologyGroup - Single Specialty