Healthcare Provider Details

I. General information

NPI: 1194472498
Provider Name (Legal Business Name): NEMG HINGHAM
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/07/2022
Last Update Date: 12/12/2023
Certification Date: 12/12/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

600 CORDWAINER DR STE 102
NORWELL MA
02061-1644
US

IV. Provider business mailing address

210 WHITING ST STE 6
HINGHAM MA
02043-3724
US

V. Phone/Fax

Practice location:
  • Phone: 781-987-3490
  • Fax: 877-384-3122
Mailing address:
  • Phone: 781-987-3490
  • Fax: 877-384-3122

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM0855X
TaxonomyAdolescent and Children Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MR. DAVID BASSANO
Title or Position: MANAGING PARTNER/COO
Credential:
Phone: 239-290-7297