Basic Information
| Provider Information | |||||||||
| NPI: | 1215165568 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | TELFORT | ||||||||
| FirstName: | JUDE | ||||||||
| MiddleName: | EMMANUEL | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 41 HIGHLAND AVE | ||||||||
| Address2: | WINCHESTER HOSPITAL ANESTHEISA DEPARTMENT | ||||||||
| City: | WINCHESTER | ||||||||
| State: | MA | ||||||||
| PostalCode: | 018901446 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7817299000 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 41 HIGHLAND AVE | ||||||||
| Address2: | WINCHESTER HOSPITAL ANESTHEISA DEPARTMENT | ||||||||
| City: | WINCHESTER | ||||||||
| State: | MA | ||||||||
| PostalCode: | 018901446 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7817299000 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/25/2009 | ||||||||
| LastUpdateDate: | 01/13/2017 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207L00000X | 255026 | MA | Y | Allopathic & Osteopathic Physicians | Anesthesiology |
No ID Information.