Healthcare Provider Details

I. General information

NPI: 1366032617
Provider Name (Legal Business Name): EMERSON ENDOSCOPY AND DIGESTIVE HEALTH CENTER, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/21/2021
Last Update Date: 11/04/2025
Certification Date: 11/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

310 BAKER AVE STE 175A
CONCORD MA
01742-2140
US

IV. Provider business mailing address

310 BAKER AVE STE 175A
CONCORD MA
01742-2140
US

V. Phone/Fax

Practice location:
  • Phone: 215-589-9024
  • Fax:
Mailing address:
  • Phone: 978-776-1710
  • Fax: 978-776-1750

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: CHRISTINE SCHULTZ
Title or Position: ADMINISTRATOR
Credential:
Phone: 978-776-1710