Dryja, Thaddeus P.

Dryja, Thaddeus P. is an individual health care provider with primary practice located at 243 Charles St , Boston MA 02114-3002. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Ophthalmology, Allopathic & Osteopathic Physicians / Clinical Pathology/Laboratory Medicine. Allopathic & Osteopathic Physicians / Ophthalmology is his primary health care specialty. Dryja, Thaddeus P. can be contacted via phone (617) 573-3319.

Contact Information

Primary practice address
243 Charles St Boston MA 02114-3002
Phone: (617) 573-3319
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Ophthalmology 207W00000X 41891 Massachusetts
Allopathic & Osteopathic Physicians / Clinical Pathology/Laboratory Medicine 207ZP0105X 41891 Massachusetts

Profile Details

NPI number 1619961968
LBN Legal business name Dryja, Thaddeus P.
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 1st, 2005
Last updated Oct 8th, 2010 - about 16 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1619961968 NPPES
Massachusetts MEDICAID 0148296

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