Healthcare Provider Details
I. General information
NPI: 1609733526
Provider Name (Legal Business Name): SYNERGY SPORTS MEDICINE
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 01/05/2026
Last Update Date: 01/05/2026
Certification Date: 12/30/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
48 DUNHAM RIDGE ROAD SUITE 4350
BEVERLY MA
01915
US
IV. Provider business mailing address
48 DUNHAM RIDGE ROAD SUITE 4350
BEVERLY MA
01915
US
V. Phone/Fax
- Phone: 315-415-8600
- Fax:
- Phone: 315-415-8600
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QM2500X |
| Taxonomy | Medical Specialty Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
THOMAS
MULROY
Title or Position: OWNER
Credential: MD
Phone: 315-415-8600