Healthcare Provider Details

I. General information

NPI: 1427599588
Provider Name (Legal Business Name): WINCHESTER ANESTHESIA ASSOCIATES 2 INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/09/2017
Last Update Date: 06/01/2021
Certification Date: 05/14/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

41 HIGHLAND AVE
WINCHESTER MA
01890-1446
US

IV. Provider business mailing address

1342 BELMONT ST STE 205
BROCKTON MA
02301-4438
US

V. Phone/Fax

Practice location:
  • Phone: 781-756-7243
  • Fax:
Mailing address:
  • Phone: 508-580-1670
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207LP2900X
TaxonomyPain Medicine (Anesthesiology) Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. LEWIS RIELEY
Title or Position: TREASURER
Credential: MD
Phone: 781-756-2190