Healthcare Provider Details

I. General information

NPI: 1821027707
Provider Name (Legal Business Name): MED SYSTEMS ASSOCIATES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/02/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3241 WESTERN BRANCH BLVD
CHESAPEAKE VA
23321-5260
US

IV. Provider business mailing address

PO BOX 7068
PORTSMOUTH VA
23707-0068
US

V. Phone/Fax

Practice location:
  • Phone: 757-686-3507
  • Fax: 757-686-0541
Mailing address:
  • Phone: 757-686-3508
  • Fax: 757-686-0541

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code246Z00000X
TaxonomyOther Specialist/Technologist
License Number
License Number State

VIII. Authorized Official

Name: ANTHONY CETRONE
Title or Position: MEDICAL DIRECTOR
Credential: MD
Phone: 757-424-4300