Healthcare Provider Details

I. General information

NPI: 1528825031
Provider Name (Legal Business Name): NVR & SDD CONVENIENT CARE PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/01/2024
Last Update Date: 03/01/2024
Certification Date: 02/28/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

339 SQUIRE RD
REVERE MA
02151-6148
US

IV. Provider business mailing address

137 TURNPIKE STREET SUBWAY RESTAURANT
NORTH ANDOVER MA
01845
US

V. Phone/Fax

Practice location:
  • Phone: 781-354-1485
  • Fax:
Mailing address:
  • Phone: 781-354-1485
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QU0200X
TaxonomyUrgent Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. ANAND KANJOLIA
Title or Position: PRESIDENT
Credential:
Phone: 413-575-8928