MEDICARE: BOSTON HERNIA & PILONIDAL CENTER PLLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208600000X	Surgery Physician

General Provider Information

NPI Number	:	1407333511
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BOSTON HERNIA & PILONIDAL CENTER PLLC

Provider Business Mailing Address
First Line	:	90 LONGFELLOW RD
Second Line	:
City	:	SUDBURY
State	:	MA
Zip	:	01776-1216
Country	:	US
Telephone Number	:	978-460-1374
Fax Number	:	857-259-4807

Provider Business Practice Location Address
First Line	:	20 WALNUT ST STE 100
Second Line	:
City	:	WELLESLEY
State	:	MA
Zip	:	02481-2104
Country	:	US
Telephone Number	:	617-466-3373
Fax Number	:	857-259-4807

Authorized Official
Title or Position	:	MANAGER
Name	:	DR. MICHAEL REINHORN
Credential	:	MD
Telephone Number	:	617-466-3373

Provider Enumeration Date	:	07/21/2018
Last Update Date	:	09/12/2023

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