Healthcare Provider Details

I. General information

NPI: 1437108222
Provider Name (Legal Business Name): SHIELDS IMAGING OF EASTERN MASSACHUSETTS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/09/2006
Last Update Date: 06/09/2025
Certification Date: 06/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

55 FOGG RD SOUTH SHORE HOSPITAL CAMPUS
SOUTH WEYMOUTH MA
02190-2432
US

IV. Provider business mailing address

700 CONGRESS ST STE 204
QUINCY MA
02169-0928
US

V. Phone/Fax

Practice location:
  • Phone: 508-897-3271
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR0200X
TaxonomyRadiology Clinic/Center
License Number4416
License Number StateMA

VIII. Authorized Official

Name: KRISTEN DELMORE
Title or Position: CFO
Credential:
Phone: 617-376-7400