Healthcare Provider Details

I. General information

NPI: 1700952322
Provider Name (Legal Business Name): NEW ENGLAND EVALUATION SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/27/2006
Last Update Date: 07/03/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

512 BROADWAY
EVERETT MA
02149-3738
US

IV. Provider business mailing address

512 BROADWAY
EVERETT MA
02149-3738
US

V. Phone/Fax

Practice location:
  • Phone: 508-984-5200
  • Fax: 508-996-8614
Mailing address:
  • Phone: 508-984-5200
  • Fax: 508-996-8614

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number305
License Number StateMA
# 2
Primary TaxonomyN
Taxonomy Code207LP2900X
TaxonomyPain Medicine (Anesthesiology) Physician
License Number34550
License Number StateMA
# 3
Primary TaxonomyY
Taxonomy Code111NR0400X
TaxonomyRehabilitation Chiropractor
License Number350
License Number StateMA

VIII. Authorized Official

Name: MRS. ELIZABETH C MEDEIROS
Title or Position: MANAGER
Credential:
Phone: 508-996-8614