Healthcare Provider Details

I. General information

NPI: 1396112405
Provider Name (Legal Business Name): ORTHOPEDICS NEW ENGLAND, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/24/2015
Last Update Date: 08/24/2015
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: 508-655-0471
  • Fax: 508-650-3547
Mailing address:
  • Phone: 508-655-0471
  • Fax: 508-650-3547

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207XX0005X
TaxonomySports Medicine (Orthopaedic Surgery) Physician
License Number155320
License Number StateMA
# 2
Primary TaxonomyN
Taxonomy Code2081P2900X
TaxonomyPain Medicine (Physical Medicine & Rehabilitation) Physician
License Number215575
License Number StateMA

VIII. Authorized Official

Name: DR. SEAN E. ROCKETT
Title or Position: PRERSIDENT
Credential: M.D.
Phone: 508-655-0471