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Provider Information for 1326025750

Please Note: Issuance of an NPI does not ensure or validate that the Health Care Provider is Licensed or Credentialed. For more information please refer to NPI: What You Need to Know

DR. BARTLEY GRAY CILENTO JR. MD

Gender: MALE

Individual NPI: 1326025750

Calendar   Last Updated:  2011-09-23
  Certification Date: 

Details

Name Value
NPI 1326025750
Enumeration Date 2005-12-28
NPI Type 1 - Individual
Sole Proprietor NO
Status Active
Mailing Address 300 LONGWOOD AVE CHILDRENS UROLOGICAL FOUNDATION
BOSTON, MA 02115-5724
United States

Phone: 617-355-8338 | Fax: 617-730-0474
View Map External Link
Primary Practice Address 300 LONGWOOD AVE CHILDRENS UROLOGICAL FOUNDATION
BOSTON, MA 02115-5724
United States

Phone: 617-355-8338 | Fax: 617-730-0474
View Map External Link
Health Information Exchange
Endpoint Type Endpoint Endpoint Description Use Content Type Affiliation Endpoint Location
Other Identifiers
Issuer State Number
Other BMC 000000009231
Other METRA 1900235
Other UHP 1900235
Other UNI7 1900235
Other HPHC 601850
Other CIG2 7007980004
Other WNH 30200111
Other FCHP 47667
MEDICAID MA 3176801
Other UNI4 1900235
Other NETHE 994862
Other HPHC AA8298
Other HEALT Z11048
Other HNE 11273
Other UNI1 1900235
Other TUFTS 156057
Other OXFORD P1698214
Other NHP 0012992
Taxonomy
Primary Taxonomy Selected Taxonomy State License Number
Yes 208800000X - Urology MA 156057