Healthcare Provider Details

I. General information

NPI: 1760961940
Provider Name (Legal Business Name): NEW ENGLAND EAR NOSE & THROAT/FACIAL PLASTIC SURGERY,P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/09/2018
Last Update Date: 08/09/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

198 MASSACHUSETTS AVE STE 103
NORTH ANDOVER MA
01845-4143
US

IV. Provider business mailing address

198 MASSACHUSETTS AVE STE 103
NORTH ANDOVER MA
01845-4143
US

V. Phone/Fax

Practice location:
  • Phone: 978-685-7550
  • Fax: 978-686-5565
Mailing address:
  • Phone: 978-685-7550
  • Fax: 978-686-5565

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207YX0905X
TaxonomyOtolaryngology/Facial Plastic Surgery Physician
License Number
License Number State

VIII. Authorized Official

Name: COLLEEN BRIEN
Title or Position: OFFICE MANAGER
Credential: DO
Phone: 978-685-7550