Healthcare Provider Details

I. General information

NPI: 1760416630
Provider Name (Legal Business Name): NEW ENGLAND ORTHOPEDIC SURGEONS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/10/2006
Last Update Date: 01/18/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 BIRNIE AVE STE 201
SPRINGFIELD MA
01107-1107
US

IV. Provider business mailing address

300 BIRNIE AVE STE 201
SPRINGFIELD MA
01107-1107
US

V. Phone/Fax

Practice location:
  • Phone: 413-785-4666
  • Fax: 413-846-4756
Mailing address:
  • Phone: 413-785-4666
  • Fax: 413-846-4756

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: JOHN R CORSETTI
Title or Position: PRESIDENT
Credential: MD
Phone: 413-785-4666