Basic Information
| Provider Information | |||||||||
| NPI: | 1215084181 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | CIAMPA | ||||||||
| FirstName: | PHILIP | ||||||||
| MiddleName: | JOHN | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | II | ||||||||
| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 291 INDEPENDENCE DR | ||||||||
| Address2: | |||||||||
| City: | CHESTNUT HILL | ||||||||
| State: | MA | ||||||||
| PostalCode: | 024673628 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6175416520 | ||||||||
| FaxNumber: | 6175416444 | ||||||||
| Practice Location | |||||||||
| Address1: | 291 INDEPENDENCE DR | ||||||||
| Address2: | |||||||||
| City: | CHESTNUT HILL | ||||||||
| State: | MA | ||||||||
| PostalCode: | 02467 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6175416600 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/04/2007 | ||||||||
| LastUpdateDate: | 01/07/2021 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 01/07/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | 255786 | MA | Y | Allopathic & Osteopathic Physicians | Internal Medicine |
No ID Information.