Healthcare Provider Details

I. General information

NPI: 1457300584
Provider Name (Legal Business Name): UMASS MEMORIAL MRI - MARLBOROUGH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/08/2006
Last Update Date: 06/09/2025
Certification Date: 06/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

157 UNION ST
MARLBOROUGH MA
01752-1228
US

IV. Provider business mailing address

700 CONGRESS ST STE 204
QUINCY MA
02169-0928
US

V. Phone/Fax

Practice location:
  • Phone: 508-486-5674
  • Fax: 508-486-5451
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM1200X
TaxonomyMagnetic Resonance Imaging (MRI) Clinic/Center
License Number4WMC
License Number StateMA

VIII. Authorized Official

Name: KRISTEN DELMORE
Title or Position: CFO
Credential:
Phone: 617-376-7400