Healthcare Provider Details

I. General information

NPI: 1124321385
Provider Name (Legal Business Name): CHELSEA MRI, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/09/2010
Last Update Date: 05/09/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

265 BENTON DR SUITE 105
EAST LONGMEADOW MA
01028-3219
US

IV. Provider business mailing address

800 W CUMMINGS PARK SUITE 1350
WOBURN MA
01801-6372
US

V. Phone/Fax

Practice location:
  • Phone: 413-525-1192
  • Fax: 413-525-2168
Mailing address:
  • Phone: 781-569-6541
  • Fax: 781-569-6557

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM1200X
TaxonomyMagnetic Resonance Imaging (MRI) Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: ROBERT A SANTAMARIA
Title or Position: CFO
Credential:
Phone: 781-569-6541