Healthcare Provider Details

I. General information

NPI: 1891711495
Provider Name (Legal Business Name): NEWTON-WELLESLEY OBSTETRICS & GYNECOLOGY PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/15/2006
Last Update Date: 05/01/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2000 WASHINGTON ST SUITE 768
NEWTON MA
02462-1650
US

IV. Provider business mailing address

2000 WASHINGTON ST SUITE 768
NEWTON MA
02462-1650
US

V. Phone/Fax

Practice location:
  • Phone: 617-332-2345
  • Fax: 617-332-0435
Mailing address:
  • Phone: 617-332-2345
  • Fax: 617-332-0435

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: MS. PATRICIA G BARYLICK
Title or Position: PRACTICE ADMINISTRATOR
Credential:
Phone: 617-332-2345