Healthcare Provider Details

I. General information

NPI: 1255765988
Provider Name (Legal Business Name): KEW GROUP INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/29/2013
Last Update Date: 01/08/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

840 MEMORIAL DR 4TH FLOOR
CAMBRIDGE MA
02139-3789
US

IV. Provider business mailing address

840 MEMORIAL DR 4TH FLOOR
CAMBRIDGE MA
02139-3789
US

V. Phone/Fax

Practice location:
  • Phone: 617-945-7922
  • Fax: 857-242-3949
Mailing address:
  • Phone: 617-945-7922
  • Fax: 857-242-3949

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code291U00000X
TaxonomyClinical Medical Laboratory
License Number22D2060722
License Number StateMA

VIII. Authorized Official

Name: SCOTT R SCHELL
Title or Position: PRESIDENT AND CEO
Credential: MD
Phone: 617-945-7922