Healthcare Provider Details

I. General information

NPI: 1730126871
Provider Name (Legal Business Name): SENIOR HEALTHCARE ASSOCIATES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/31/2006
Last Update Date: 11/06/2020
Certification Date: 11/06/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

83 LITTLEFIELD RD
NEWTON MA
02459-3010
US

IV. Provider business mailing address

83 LITTLEFIELD RD
NEWTON MA
02459-3010
US

V. Phone/Fax

Practice location:
  • Phone: 781-642-1859
  • Fax:
Mailing address:
  • Phone: 781-642-1859
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code207RG0300X
TaxonomyGeriatric Medicine (Internal Medicine) Physician
License Number
License Number State

VIII. Authorized Official

Name: MRS. MICHELE HURD
Title or Position: CREDENTIALING/CONTRACTING
Credential:
Phone: 603-974-2833