Healthcare Provider Details
I. General information
NPI: 1831148014
Provider Name (Legal Business Name): MASSACHUSETTS BAY REGIONAL MRI LIMITED PARTNERSHIP
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 05/08/2006
Last Update Date: 06/09/2025
Certification Date: 06/09/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
161 GRANITE AVE
DORCHESTER CENTER MA
02124-5453
US
IV. Provider business mailing address
700 CONGRESS ST STE 204
QUINCY MA
02169-0928
US
V. Phone/Fax
- Phone: 617-282-4141
- Fax: 508-897-3699
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QM1200X |
| Taxonomy | Magnetic Resonance Imaging (MRI) Clinic/Center |
| License Number | 4417 |
| License Number State | MA |
VIII. Authorized Official
Name:
KRISTEN
DELMORE
Title or Position: CFO
Credential:
Phone: 617-376-7400