1417319153 NPI number — NEUROLOGY CENTER OF NEW ENGLAND PC

Table of content: (NPI 1417319153)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1417319153 NPI number — NEUROLOGY CENTER OF NEW ENGLAND PC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
NEUROLOGY CENTER OF NEW ENGLAND PC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1417319153
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/22/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
944 WASHINGTON ST
Provider Second Line Business Mailing Address:
SUITE 1
Provider Business Mailing Address City Name:
SOUTH EASTON
Provider Business Mailing Address State Name:
MA
Provider Business Mailing Address Postal Code:
02375-1177
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
508-238-8646
Provider Business Mailing Address Fax Number:
508-230-9772

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
16 CHESTNUT ST
Provider Second Line Business Practice Location Address:
SUITE 100
Provider Business Practice Location Address City Name:
FOXBORO
Provider Business Practice Location Address State Name:
MA
Provider Business Practice Location Address Postal Code:
02035-1472
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
781-551-5812
Provider Business Practice Location Address Fax Number:
508-698-8671
Provider Enumeration Date:
03/22/2016

Additional Information

Authorized Official

Authorized Official Last Name:
NAPOLI
Authorized Official First Name:
SALVATORE
Authorized Official Middle Name:
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
781-551-5812

Provider Taxonomy Codes

  • Taxonomy code: 225100000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 225X00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)





Copyright © 2007-2024 www.npivalidator.com