Healthcare Provider Details

I. General information

NPI: 1497817621
Provider Name (Legal Business Name): WELLESLEY WOMEN'S CARE, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/14/2006
Last Update Date: 06/05/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2000 WASHINGTON STREET SUITE 764
NEWTON MA
02462-1628
US

IV. Provider business mailing address

2000 WASHINGTON STREET SUITE 764
NEWTON MA
02462-1628
US

V. Phone/Fax

Practice location:
  • Phone: 617-965-7800
  • Fax: 617-965-4581
Mailing address:
  • Phone: 617-965-7800
  • Fax: 617-965-4581

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. THOMAS L BEATTY
Title or Position: PRESIDENT
Credential: M.D.
Phone: 617-965-7800