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Provider Information for 1619162328

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. ISAAC SAMUEL KOHANE MD, PHD

Gender: MALE

Individual NPI: 1619162328

Calendar   Last Updated:  2007-09-06
  Certification Date: 

Details

Name Value
NPI 1619162328
Enumeration Date 2007-09-06
NPI Type 1 - Individual
Sole Proprietor NO
Status Active
Mailing Address 300 LONGWOOD AVE ENDERS 624
BOSTON, MA 02115-5724
United States

Phone: 619-919-2184 | Fax: 617-730-0921
View Map External Link
Primary Practice Address 300 LONGWOOD AVE DIVISION OF ENDOCRINOLOGY
BOSTON, MA 02115-5724
United States

Phone: 617-355-7476 | Fax: 617-730-0194
View Map External Link
Health Information Exchange
Endpoint Type Endpoint Endpoint Description Use Content Type Affiliation Endpoint Location
Other Identifiers
Issuer State Number
MEDICAID MA 3088820
Taxonomy
Primary Taxonomy Selected Taxonomy State License Number
Yes 207RE0101X - Internal Medicine Endocrinology, Diabetes & Metabolism MA 73541