Healthcare Provider Details

I. General information

NPI: 1033259460
Provider Name (Legal Business Name): NORTH SUBURBAN SURGICAL ASSOCIATES PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/07/2007
Last Update Date: 07/06/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3 WOODLAND ROAD SUITE 212
STONEHAM MA
02180
US

IV. Provider business mailing address

3 WOODLAND ROAD SUITE 212
STONEHAM MA
02180
US

V. Phone/Fax

Practice location:
  • Phone: 781-662-2288
  • Fax: 781-662-7546
Mailing address:
  • Phone: 781-662-2288
  • Fax: 781-662-7546

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number57581
License Number StateMA

VIII. Authorized Official

Name: DR. DARIUS AMERI
Title or Position: PRESIDENT OF CORPORATION
Credential: MD
Phone: 781-662-2288