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NPI Code Detail

MEDICARE: LONGWOOD ACADEMIC PHYSICIANS, LLC

MEDICARE: LONGWOOD ACADEMIC PHYSICIANS, LLC
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
1207RC0001XClinical Cardiac Electrophysiology Physician76993MA
2207RC0000XCardiovascular Disease Physician76993MA

General Provider Information

NPI Number : 1922367168
Entity Type Code : Organization
Provider Name (Legal Business Name) : LONGWOOD ACADEMIC PHYSICIANS, LLC
Provider Business Mailing Address
First Line : 198 GROTON RD
Second Line : SUITE 2
City : AYER
State : MA
Zip : 01432-1177
Country : US
Telephone Number : 978-772-3793
Fax Number : 978-772-3797
Provider Business Practice Location Address
First Line : 198 GROTON RD
Second Line : SUITE 2
City : AYER
State : MA
Zip : 01432-1177
Country : US
Telephone Number : 978-772-3793
Fax Number : 978-772-3797
Authorized Official
Title or Position : DIRECTOR OF NETWORK OPERATIONS
Name : JOHN DIGIORGIO
Credential :
Telephone Number : 617-632-7373
Provider Enumeration Date : 05/09/2012
Last Update Date : 05/09/2012

Similar Medicare Providers

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Practice Location Address:
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AYER, MA
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AYER, MA
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Directions to “LONGWOOD ACADEMIC PHYSICIANS, LLC ” Practice Location

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