Healthcare Provider Details

I. General information

NPI: 1912278441
Provider Name (Legal Business Name): ORTHOPEDIC SURGERY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/13/2012
Last Update Date: 07/15/2021
Certification Date: 07/15/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

92 MONTVALE AVE SUITE 1400
STONEHAM MA
02180
US

IV. Provider business mailing address

92 MONTVALE AVE SUITE 1400
STONEHAM MA
02180-3647
US

V. Phone/Fax

Practice location:
  • Phone: 781-279-7040
  • Fax: 781-279-8430
Mailing address:
  • Phone: 781-279-7040
  • Fax: 781-279-8430

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number StateMA
# 2
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number StateMA

VIII. Authorized Official

Name: ABRAHAM T SHURLAND
Title or Position: PRESIDENT
Credential: MD
Phone: 781-279-7040