Healthcare Provider Details
I. General information
NPI: 1992737761
Provider Name (Legal Business Name): NEWTON-WELLESLEY HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 07/06/2006
Last Update Date: 10/27/2022
Certification Date: 10/27/2022
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2014 WASHINGTON ST
NEWTON MA
02462-1607
US
IV. Provider business mailing address
2014 WASHINGTON ST
NEWTON MA
02462-1607
US
V. Phone/Fax
- Phone: 617-243-6000
- Fax: 617-243-6954
- Phone: 617-243-6000
- Fax: 617-243-6954
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207Q00000X |
| Taxonomy | Family Medicine Physician |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 261QM1300X |
| Taxonomy | Multi-Specialty Clinic/Center |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 273R00000X |
| Taxonomy | Psychiatric Hospital Unit |
| License Number | |
| License Number State | |
| # 4 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 282N00000X |
| Taxonomy | General Acute Care Hospital |
| License Number | 2075 |
| License Number State | MA |
VIII. Authorized Official
Name:
VINCENT
MCDERMOTT
Title or Position: SENIOR VP OF FINANCE/CFO
Credential:
Phone: 617-243-6381