Healthcare Provider Details

I. General information

NPI: 1912122441
Provider Name (Legal Business Name): NEEDHAM PEDIATRICS P C
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/17/2007
Last Update Date: 10/27/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

111 LINCOLN ST
NEEDHAM MA
02492-2900
US

IV. Provider business mailing address

111 LINCOLN ST
NEEDHAM MA
02492-2900
US

V. Phone/Fax

Practice location:
  • Phone: 781-444-7186
  • Fax: 781-449-5361
Mailing address:
  • Phone: 781-444-7186
  • Fax: 781-449-5361

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code173000000X
TaxonomyLegal Medicine
License Number
License Number State

VIII. Authorized Official

Name: DR. NORMAN L ROSIN
Title or Position: PRESIDENT
Credential: MD
Phone: 781-444-7186