Healthcare Provider Details

I. General information

NPI: 1902024292
Provider Name (Legal Business Name): NEW ENGLAND CARDIOLOGY, L.L.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/23/2007
Last Update Date: 03/02/2023
Certification Date: 03/02/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

25 MARSTON ST STE 404
LAWRENCE MA
01841-2359
US

IV. Provider business mailing address

25 MARSTON ST STE 404
LAWRENCE MA
01841-2359
US

V. Phone/Fax

Practice location:
  • Phone: 978-989-8911
  • Fax: 978-989-0748
Mailing address:
  • Phone: 978-989-8911
  • Fax: 978-989-0748

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207UN0901X
TaxonomyNuclear Cardiology Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. DAVOR B. KVATERNIK
Title or Position: PRESIDENT
Credential: M.D.
Phone: 603-898-7622