Mack, Jennifer Williams

Mack, Jennifer Williams is an individual health care provider with primary practice located at 44 Binney St 454 Suite 21, Boston MA 02115. She recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatric Hematology-Oncology, which is considered as her primary health care specialty. Mack, Jennifer Williams can be contacted via phone (617) 632-6818.

Contact Information

Primary practice address
44 Binney St 454 Suite 21 Boston MA 02115
Phone: (617) 632-6818
Fax: (617) 632-2270
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatric Hematology-Oncology 2080P0207X 212529 Massachusetts

Profile Details

NPI number 1225006398
LBN Legal business name Mack, Jennifer Williams
Credentials MD MPH
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 14th, 2006
Last updated Mar 13th, 2012 - about 13 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1225006398 NPPES
Massachusetts Other J27212 BLUE CROSS BLUE SHIELD
Massachusetts Other AA11960 BLUE CROSS BLUE SHIELD
Massachusetts Other 212529 BLUE CROSS BLUE SHIELD
Massachusetts MEDICAID 2036436 BLUE CROSS BLUE SHIELD

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