Healthcare Provider Details

I. General information

NPI: 1386820678
Provider Name (Legal Business Name): NEW ENGLAND PAIN ASSOCIATES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/16/2008
Last Update Date: 03/11/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

747 MAIN ST STE. 201
CONCORD MA
01742-3302
US

IV. Provider business mailing address

42 HEMINGWAY DR
RIVERSIDE RI
02915-2224
US

V. Phone/Fax

Practice location:
  • Phone: 978-371-0900
  • Fax: 978-371-0915
Mailing address:
  • Phone: 401-490-2130
  • Fax: 401-435-2483

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: M.D.
Phone: 401-490-2130