Healthcare Provider Details

I. General information

NPI: 1598756132
Provider Name (Legal Business Name): HEART CENTER OF METROWEST INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/02/2005
Last Update Date: 04/08/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

99 LINCOLN ST 2ND FLOOR
FRAMINGHAM MA
01702-6327
US

IV. Provider business mailing address

99 LINCOLN ST 2ND FLOOR
FRAMINGHAM MA
01702-6327
US

V. Phone/Fax

Practice location:
  • Phone: 508-875-4811
  • Fax: 508-875-5942
Mailing address:
  • Phone: 508-875-4811
  • Fax: 508-875-5942

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number
License Number State

VIII. Authorized Official

Name: HOWARD A SUSSMAN
Title or Position: BOARD MEMBER
Credential: MD
Phone: 508-875-4811