Healthcare Provider Details

I. General information

NPI: 1356695985
Provider Name (Legal Business Name): NEW ENGLAND CONSULTANTS IN GASTROENTEROLOGY AND HEPATOLOGY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/05/2012
Last Update Date: 11/05/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

855 WORCESTER RD
FRAMINGHAM MA
01701-5258
US

IV. Provider business mailing address

855 WORCESTER RD
FRAMINGHAM MA
01701-5258
US

V. Phone/Fax

Practice location:
  • Phone: 508-872-0508
  • Fax: 508-872-0588
Mailing address:
  • Phone: 508-872-0508
  • Fax: 508-872-0588

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code174400000X
TaxonomySpecialist
License Number230367
License Number StateMA
# 2
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number230294
License Number StateMA

VIII. Authorized Official

Name: DR. KHALID AZIZ
Title or Position: PHYSICIAN
Credential: M.D.
Phone: 508-872-0508