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General NPI Number Information
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NPI Number | 1093670515
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Entity Type | Organization
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Legal Business Name | UMASS MEMORIAL MEDICAL GROUP, INC.
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Dates
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Enumeration Date | 12/17/2025
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Last Update Date | 12/17/2025
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Provider Practice Location Address
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Address Line | 194 WEST ST STE 10
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City | MILFORD
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State | MA
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Zip | 01757-2274
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Country | US
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Telephone | 508-381-6590
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Fax | 508-381-6593
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Provider Business Mailing Address
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Address Line | P.O. BOX 415348 ATTN: PROVIDER ENROLLMENT
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City | BOSTON
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State | MA
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Zip | 02241
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Country | US
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Telephone | 508-334-8015
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Fax | 508-334-8105
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Authorized Official
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Title or Position | DIRECTOR, MEDICAL STAFF SERVICES
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Name | ANDREW SCIANNAMEO
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Credential |
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Telephone | 508-450-0098
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QS1200X
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Taxonomy Name | Sleep Disorder Diagnostic Clinic/Center
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License Number |
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License Number State |
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