Children'S Sports Medicine Foundation

LBN: Children'S Sports Medicine Foundation
Children'S Sports Medicine Foundation is an health care organization with primary practice located at 319 Longwood Ave , Boston MA 02115-5728. The organization recently has only one registered license in Podiatric Medicine & Surgery Service Providers / Sports Medicine, which is considered as the primary health care specialty. Children'S Sports Medicine Foundation can be contacted via phone (617) 355-5971, or through Micheli, Lyle J via phone (617) 355-5971.

Contact Information

Primary practice address
319 Longwood Ave Boston MA 02115-5728
Phone: (617) 355-5971
Fax: (617) 730-0178
Website:
Map and Directions
Authorized official contact:
Name: Micheli, Lyle J Doctor of Medicine (MD)
Phone: (617) 355-5971

Health care specialties

SpecialtyCodeLicense #State
Podiatric Medicine & Surgery Service Providers / Sports Medicine 213ES0000X

Profile Details

NPI number 1861680720
LBN Legal business name Children'S Sports Medicine Foundation
DBA Doing business as
Authorized official Micheli, Lyle J Doctor of Medicine (MD)
Entity Organization
Organization subpart 1 No
Enumeration date Oct 4th, 2007
Last updated Oct 4th, 2007 - about 18 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1861680720 NPPES
Massachusetts MEDICAID 9782621
Massachusetts Other M14628

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