Healthcare Provider Details
I. General information
NPI: 1235174699
Provider Name (Legal Business Name): ORTHOPAEDIC ASSOCIATES OF MARLBORO, PC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 06/19/2006
Last Update Date: 12/17/2019
Certification Date: 12/17/2019
Deactivation Date:
Reactivation Date:
III. Provider practice location address
65 FREMONT ST
MARLBORO MA
01752-1271
US
IV. Provider business mailing address
65 FREMONT ST OFC 1
MARLBOROUGH MA
01752-1271
US
V. Phone/Fax
- Phone: 508-485-3665
- Fax:
- Phone: 508-485-3665
- Fax: 508-485-0899
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 174400000X |
| Taxonomy | Specialist |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
REBECCA
HUNT
Title or Position: BUSINESS OFFICE LEAD
Credential:
Phone: 508-485-3665