Healthcare Provider Details

I. General information

NPI: 1922182419
Provider Name (Legal Business Name): BOSTON SURGERY CENTER, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/24/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

85 1ST AVE
WALTHAM MA
02451-1105
US

IV. Provider business mailing address

20 HOPE AVE SUITE 107
WALTHAM MA
02453-2721
US

V. Phone/Fax

Practice location:
  • Phone: 781-647-7226
  • Fax:
Mailing address:
  • Phone: 781-894-5522
  • Fax: 781-894-1417

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208VP0014X
TaxonomyInterventional Pain Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QA1903X
TaxonomyAmbulatory Surgical Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: STEVEN NATHIN
Title or Position: PRESIDENT
Credential: M.D.
Phone: 781-647-7226