Basic Information
| Provider Information | |||||||||
| NPI: | 1326086612 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | FELSON | ||||||||
| FirstName: | JERRY | ||||||||
| MiddleName: | M | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 52 OAK ST | ||||||||
| Address2: | |||||||||
| City: | PLYMPTON | ||||||||
| State: | MA | ||||||||
| PostalCode: | 023671305 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6175224400 | ||||||||
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| Practice Location | |||||||||
| Address1: | 49 ROBINWOOD AVE | ||||||||
| Address2: | ARBOUR HEALTH SYSTEM | ||||||||
| City: | BOSTON | ||||||||
| State: | MA | ||||||||
| PostalCode: | 02130 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6175224400 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 06/02/2006 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | X | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | 40631 | MA | Y | Allopathic & Osteopathic Physicians | Internal Medicine |
No ID Information.