1528172038 NPI number — NEW ENGLAND INPATIENT SPECIALISTS LLC

Table of content: (NPI 1528172038)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1528172038 NPI number — NEW ENGLAND INPATIENT SPECIALISTS LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
NEW ENGLAND INPATIENT SPECIALISTS 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:
1528172038
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
05/21/2009
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:
41 HIGHLAND AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
WINCHESTER
Provider Business Practice Location Address State Name:
MA
Provider Business Practice Location Address Postal Code:
01890-1446
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
781-729-9000
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
08/19/2006

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
JALEEL
Authorized Official First Name:
MOHAMMED
Authorized Official Middle Name:
Authorized Official Title or Position:
HEAD PHYSICIAN
Authorized Official Telephone Number:
781-729-9000

Provider Taxonomy Codes

  • Taxonomy code: 207R00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 625686 . This is a "TUFTS" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 9761781 , issued by the state of ( MA ) . This identifiers is of the category "MEDICAID".
  • Identifier: M19149 . This is a "BLUE SHIELD" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 0037508 . This is a "NEIGHBORHOOD HEALTH" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".