1093899346 NPI number — NEW ENGLAND OB/GYN ASSOCIATES,INC

Table of content: (NPI 1093899346)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1093899346 NPI number — NEW ENGLAND OB/GYN ASSOCIATES,INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
NEW ENGLAND OB/GYN ASSOCIATES,INC
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:
1093899346
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
01/03/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
27 BOYLSTON ST STE 320
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CHESTNUT HILL
Provider Business Mailing Address State Name:
MA
Provider Business Mailing Address Postal Code:
02467-1747
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
617-731-3400
Provider Business Mailing Address Fax Number:
617-566-2224

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
27 BOYLSTON ST STE 320
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CHESTNUT HILL
Provider Business Practice Location Address State Name:
MA
Provider Business Practice Location Address Postal Code:
02467-1747
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
617-731-3400
Provider Business Practice Location Address Fax Number:
617-566-2224
Provider Enumeration Date:
10/24/2006

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
ZAJAC
Authorized Official First Name:
LISA
Authorized Official Middle Name:
Authorized Official Title or Position:
PRACTICE ADMINISTRATOR
Authorized Official Telephone Number:
617-731-3400

Provider Taxonomy Codes

  • Taxonomy code: 207VX0000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: NE M10725 . This is a "BLUE CROSS INS" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 9707468 , issued by the state of ( MA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 702828 . This is a "TUFTS INSURANCE" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".