Healthcare Provider Details

I. General information

NPI: 1437197092
Provider Name (Legal Business Name): NEW ENGLAND EAR NOSE & THROAT/FACIAL PLASTIC SURGERY,P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/03/2006
Last Update Date: 08/15/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

198 MASSACHUSETTS AVE #103
N ANDOVER MA
01845-4143
US

IV. Provider business mailing address

198 MASSACHUSETTS AVE #103
N ANDOVER MA
01845-4143
US

V. Phone/Fax

Practice location:
  • Phone: 978-685-7550
  • Fax: 978-686-5565
Mailing address:
  • Phone: 978-685-7550
  • Fax: 978-686-5565

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number
License Number StateMA

VIII. Authorized Official

Name: WILLIAM S POSTAL
Title or Position: PRESIDENT
Credential: MD
Phone: 978-685-7550