Mela, Theofanie

Mela, Theofanie is an individual health care provider with primary practice located at 55 Fruit St Electrophysiology Lab Arrhythmia Service Grb 109, Boston MA 02114-2621. She recently has 3 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Internal Medicine, Allopathic & Osteopathic Physicians / Cardiovascular Disease, Allopathic & Osteopathic Physicians / Clinical Cardiac Electrophysiology. Allopathic & Osteopathic Physicians / Cardiovascular Disease is her primary health care specialty. Mela, Theofanie can be contacted via phone (617) 726-4662.

Contact Information

Primary practice address
55 Fruit St Electrophysiology Lab Arrhythmia Service Grb 109 Boston MA 02114-2621
Fax: (617) 726-3852
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X 80414 Massachusetts
Allopathic & Osteopathic Physicians / Cardiovascular Disease 207RC0000X 80414 Massachusetts
Allopathic & Osteopathic Physicians / Clinical Cardiac Electrophysiology 207RC0001X 80414 Massachusetts

Profile Details

NPI number 1366423832
LBN Legal business name Mela, Theofanie
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 10th, 2005
Last updated Nov 26th, 2012 - about 12 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 1366423832 NPPES
Massachusetts Other 779923 TUFTS HEALTH PLAN
Massachusetts Other J21120 TUFTS HEALTH PLAN
Massachusetts MEDICAID 3193659 TUFTS HEALTH PLAN

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