1447279617 NPI number — NEW ENGLAND COMPREHENSIVE FOOT & ANKLE GROUP, LLC

Table of content: (NPI 1447279617)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1447279617 NPI number — NEW ENGLAND COMPREHENSIVE FOOT & ANKLE GROUP, LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
NEW ENGLAND COMPREHENSIVE FOOT & ANKLE GROUP, LLC
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:
1447279617
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/04/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2211 MASSACHUSETTS AVE
Provider Second Line Business Mailing Address:
SUITE1
Provider Business Mailing Address City Name:
CAMBRIDGE
Provider Business Mailing Address State Name:
MA
Provider Business Mailing Address Postal Code:
02140-1211
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
617-821-6329
Provider Business Mailing Address Fax Number:
617-354-3877

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2211 MASSACHUSETTS AVE
Provider Second Line Business Practice Location Address:
SUITE 1
Provider Business Practice Location Address City Name:
CAMBRIDGE
Provider Business Practice Location Address State Name:
MA
Provider Business Practice Location Address Postal Code:
02140-1211
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
617-821-6329
Provider Business Practice Location Address Fax Number:
617-354-3877
Provider Enumeration Date:
07/19/2006

Additional Information

Authorized Official

Authorized Official Last Name:
DO
Authorized Official First Name:
YENA
Authorized Official Middle Name:
HOANG
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
305-975-5800

Provider Taxonomy Codes

  • Taxonomy code: 213ES0103X , with the licence number:  2217 , 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: 7347225 . This is a "CIGNA HEALTHCARE" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 90539 . This is a "FALLON COMMUNITY HEALTH" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 95995101 . This is a "NETWORK HEALTH" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: AA69029 . This is a "HARVARD PILGRIM" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 1447279617 . This is a "NETWORK HEALTH PLAN" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 1447279617 . This is a "NEIGHBORHOOD HEALTH PLAN" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 649085 . This is a "TUFTS" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 9746820 , issued by the state of ( MA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 7626827 . This is a "AETNA" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: AA96300 . This is a "HARVARD PILGRIM" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: Y77361 . This is a "BLUE CROSS BLUE SHIELD" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".




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