Mansbach, Jonathan M

Mansbach, Jonathan M is an individual health care provider with primary practice located at 300 Longwood Ave , Boston MA 02115-5724. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Adolescent Medicine, Allopathic & Osteopathic Physicians / Pediatrics. Allopathic & Osteopathic Physicians / Adolescent Medicine is his primary health care specialty. Mansbach, Jonathan M can be contacted via phone (617) 355-7181.

Contact Information

Primary practice address
300 Longwood Ave Boston MA 02115-5724
Phone: (617) 355-7181
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Adolescent Medicine 207RA0000X 160172 Massachusetts
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 160172 Massachusetts
Allopathic & Osteopathic Physicians / Adolescent Medicine 2080A0000X 160172 Massachusetts

Profile Details

NPI number 1780761312
LBN Legal business name Mansbach, Jonathan M
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 1st, 2006
Last updated Sep 3rd, 2015 - about 10 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 1780761312 NPPES
Massachusetts MEDICAID 0116777

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