Healthcare Provider Details

I. General information

NPI: 1598096257
Provider Name (Legal Business Name): NEW ENGLAND PAIN ASSOCITES, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/20/2010
Last Update Date: 01/20/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

340 WOOD ROAD, SUITE 204
BRAINTREE MA
02184
US

IV. Provider business mailing address

10 CONVERSE PLACE 4TH FLOOR
WINCHESTER MA
01890
US

V. Phone/Fax

Practice location:
  • Phone: 781-843-5700
  • Fax: 781-843-5721
Mailing address:
  • Phone: 781-729-0500
  • Fax: 781-729-0581

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA1903X
TaxonomyAmbulatory Surgical Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: FATHALLA MASHALI
Title or Position: PRESIDENT
Credential: MD
Phone: 74014902103