Healthcare Provider Details

I. General information

NPI: 1346559333
Provider Name (Legal Business Name): HIGHLAND SURGICAL ASSOCIATES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/24/2010
Last Update Date: 09/24/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 HIGHLAND ST STE 222
MILTON MA
02186-3881
US

IV. Provider business mailing address

PO BOX 86
HINGHAM MA
02043-0086
US

V. Phone/Fax

Practice location:
  • Phone: 617-696-0660
  • Fax: 617-696-6655
Mailing address:
  • Phone: 781-749-9071
  • Fax: 781-749-2133

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2086S0129X
TaxonomyVascular Surgery Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. GREGORY J KECHEJIAN
Title or Position: MD
Credential: M.D.
Phone: 617-696-0660