Healthcare Provider Details

I. General information

NPI: 1295013191
Provider Name (Legal Business Name): NEW ENGLAND PRIMARY CARE ASSOCIATES P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/26/2011
Last Update Date: 03/17/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

280 MERRIMACK ST STE 103
LAWRENCE MA
01843-1780
US

IV. Provider business mailing address

280 MERRIMACK ST STE 103
LAWRENCE MA
01843-1780
US

V. Phone/Fax

Practice location:
  • Phone: 978-685-2455
  • Fax: 978-685-2459
Mailing address:
  • Phone: 978-685-2455
  • Fax: 978-685-2459

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: RAMI RUSTUM
Title or Position: PRESIDENT
Credential: M.D
Phone: 978-685-2455