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General NPI Number Information
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NPI Number | 1144557737
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Entity Type | Organization
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Legal Business Name | EZA HEALTHCARE MANAGEMENT, LLC
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Dates
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Enumeration Date | 11/03/2009
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Last Update Date | 11/03/2009
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Provider Practice Location Address
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Address Line | 244.1 SMITH STREET
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City | LOWELL
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State | MA
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Zip | 01851
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Country | US
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Telephone | 617-407-2112
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Fax |
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Provider Business Mailing Address
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Address Line | 244 SMITH STREET
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City | LOWELL
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State | MA
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Zip | 01851
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CONSULTANT
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Name | DMITRY BURSHTEYN
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Credential |
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Telephone | 617-633-7121
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QA0600X
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Taxonomy Name | Adult Day Care Clinic/Center
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License Number |
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License Number State |
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