Healthcare Provider Details

I. General information

NPI: 1356340871
Provider Name (Legal Business Name): DIAGNOSTIC ULTRASOUND ASSOCIATES, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/18/2005
Last Update Date: 10/29/2025
Certification Date: 10/29/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 BROOKLINE PL SUITE 506
BROOKLINE MA
02445-7224
US

IV. Provider business mailing address

1 BROOKLINE PL STE 506
BROOKLINE MA
02445-7277
US

V. Phone/Fax

Practice location:
  • Phone: 617-739-0245
  • Fax: 617-738-6703
Mailing address:
  • Phone: 617-739-0245
  • Fax: 617-738-6703

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code2085U0001X
TaxonomyDiagnostic Ultrasound Physician
License Number
License Number State

VIII. Authorized Official

Name: THOMAS SHIPP
Title or Position: PRESIDENT
Credential: MD
Phone: 617-739-0245