Healthcare Provider Details

I. General information

NPI: 1720557507
Provider Name (Legal Business Name): ORTHOPEDICS NEW ENGLAND 3, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/21/2018
Last Update Date: 11/21/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

313 SPEEN ST
NATICK MA
01760-1538
US

IV. Provider business mailing address

313 SPEEN ST
NATICK MA
01760-1538
US

V. Phone/Fax

Practice location:
  • Phone: 508-720-3630
  • Fax:
Mailing address:
  • Phone: 508-720-3630
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207XS0106X
TaxonomyOrthopaedic Hand Surgery Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code207XS0117X
TaxonomyOrthopaedic Surgery of the Spine Physician
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code207XX0005X
TaxonomySports Medicine (Orthopaedic Surgery) Physician
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code208VP0014X
TaxonomyInterventional Pain Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: SEAN E ROCKETT
Title or Position: PRESIDENT
Credential: MD
Phone: 508-720-3630