Healthcare Provider Details

I. General information

NPI: 1942654850
Provider Name (Legal Business Name): NEW ENGLAND CONSULTANTS IN GASTROENTEROLOGY AND HEPATOLOGY PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/17/2016
Last Update Date: 04/17/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

43 LINCOLN ST
FRAMINGHAM MA
01702-8205
US

IV. Provider business mailing address

43 LINCOLN ST
FRAMINGHAM MA
01702-8205
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 TaxonomyY
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License Number230294
License Number StateMA

VIII. Authorized Official

Name: PEGGY BOWER
Title or Position: OFFICE MANAGER
Credential:
Phone: 508-872-0508