Healthcare Provider Details

I. General information

NPI: 1649805193
Provider Name (Legal Business Name): NEWH OBGYN, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/05/2020
Last Update Date: 03/05/2020
Certification Date: 03/05/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

800 W CUMMINGS PARK STE 4050
WOBURN MA
01801-6372
US

IV. Provider business mailing address

800 W CUMMINGS PARK STE 4050
WOBURN MA
01801-6372
US

V. Phone/Fax

Practice location:
  • Phone: 781-787-3003
  • Fax: 781-281-2406
Mailing address:
  • Phone: 781-787-3003
  • Fax: 781-281-2406

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number
License Number State

VIII. Authorized Official

Name: JODY H BLUMBERG
Title or Position: CEO
Credential: MBA
Phone: 781-787-3003