1497854905 NPI number — DRS. SMITH & STEWART

Table of content: (NPI 1497854905)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1497854905 NPI number — DRS. SMITH & STEWART

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
DRS. SMITH & STEWART
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:
1497854905
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/22/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
10 LANGLEY RD
Provider Second Line Business Mailing Address:
SUITE 201
Provider Business Mailing Address City Name:
NEWTON CENTRE
Provider Business Mailing Address State Name:
MA
Provider Business Mailing Address Postal Code:
02459-1972
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
617-527-8186
Provider Business Mailing Address Fax Number:
617-965-0820

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
10 LANGLEY RD
Provider Second Line Business Practice Location Address:
SUITE 201
Provider Business Practice Location Address City Name:
NEWTON CENTRE
Provider Business Practice Location Address State Name:
MA
Provider Business Practice Location Address Postal Code:
02459-1972
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
617-527-8186
Provider Business Practice Location Address Fax Number:
617-965-0820
Provider Enumeration Date:
09/21/2006

Additional Information

Authorized Official

Authorized Official Last Name:
SMITH
Authorized Official First Name:
LLOYD
Authorized Official Middle Name:
STEVEN
Authorized Official Title or Position:
PARTNER
Authorized Official Telephone Number:
617-527-8186

Provider Taxonomy Codes

  • Taxonomy code: 213E00000X , with the licence number:  1461 , registered in the state of MA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 33099 . This is a "LSS PILGRIM NUMBER" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 0009413 . This is a "NEIGHBORHOOD HEALTH" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 0860818-001 . This is a "J. STEWART'S CIGNA NUMBER" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 33101 . This is a "JPS PILGRIM #" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 701643 . This is a "TUFTS GROUP NUMBER" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 0083230-001 . This is a "L. SMITH'S CIGNA NUMBER" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 0093925 . This is a "JPS AETNA NUMBER" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 700541 . This is a "LSS TUFTS IND. #" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: S007950 . This is a "CHAMPUS" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 0087833 . This is a "LSS AETNA NUMBER" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 701627 . This is a "JPS TUFTS IND. #" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 9721975 , issued by the state of ( MA ) . This identifiers is of the category "MEDICAID".




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