Healthcare Provider Details

I. General information

NPI: 1487875498
Provider Name (Legal Business Name): NEW ENGLAND MEDICAL CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/01/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

750 WASHINGTON ST NEMC # 391
BOSTON MA
02111-1526
US

IV. Provider business mailing address

42 8TH ST #3114
CHARLESTOWN MA
02129-4207
US

V. Phone/Fax

Practice location:
  • Phone: 617-636-5866
  • Fax:
Mailing address:
  • Phone: 617-241-5975
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code282NC0060X
TaxonomyCritical Access Hospital
License Number218938
License Number StateMA

VIII. Authorized Official

Name: MARIE ANNE SOSA
Title or Position: NEPHROLOGY FELLOW
Credential:
Phone: 617-241-5975