Basic Information
| Provider Information | |||||||||
| NPI: | 1326274200 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | TIGER | ||||||||
| FirstName: | JEFFREY | ||||||||
| MiddleName: | BAUER | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 67 S. BEDFORD STREET | ||||||||
| Address2: | LAHEY HOSPITAL AND MEDICAL CENTER | ||||||||
| City: | BURLINGTON | ||||||||
| State: | MA | ||||||||
| PostalCode: | 018035108 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7817445115 | ||||||||
| FaxNumber: | 7817445687 | ||||||||
| Practice Location | |||||||||
| Address1: | 67 S. BEDFORD STREET | ||||||||
| Address2: | LAHEY HOSPITAL AND MEDICAL CENTER | ||||||||
| City: | BURLINGTON | ||||||||
| State: | MA | ||||||||
| PostalCode: | 018035108 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7817445115 | ||||||||
| FaxNumber: | 7817445687 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/04/2009 | ||||||||
| LastUpdateDate: | 10/05/2020 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 10/05/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207ND0101X | 258670 | MA | Y | Allopathic & Osteopathic Physicians | Dermatology | MOHS-Micrographic Surgery | 207N00000X | 258670 | MA | N | Allopathic & Osteopathic Physicians | Dermatology |
No ID Information.