Healthcare Provider Details

I. General information

NPI: 1326137704
Provider Name (Legal Business Name): MARK H. ABENSOHN, M.D., L.L.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/12/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

266 MAIN ST UNIT 4
MEDFIELD MA
02052-2043
US

IV. Provider business mailing address

PO BOX 469
MEDFIELD MA
02052-0469
US

V. Phone/Fax

Practice location:
  • Phone: 508-359-8141
  • Fax: 508-359-8005
Mailing address:
  • Phone: 508-359-8141
  • Fax: 508-359-8005

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number56322, 157592
License Number StateMA

VIII. Authorized Official

Name: DR. MARK HOWARD ABENSOHN
Title or Position: OWNER
Credential: M.D.
Phone: 508-359-8141