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General NPI Number Information
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NPI Number | 1215684477
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Entity Type | Organization
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Legal Business Name | BOSTON UROGYN
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Dates
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Enumeration Date | 03/08/2022
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Last Update Date | 03/08/2022
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Provider Practice Location Address
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Address Line | 70 WALNUT ST
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City | WELLESLEY
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State | MA
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Zip | 02481-2135
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Country | US
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Telephone | 617-340-6446
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Fax | 617-674-3440
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Provider Business Mailing Address
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Address Line | 70 WALNUT ST
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City | WELLESLEY
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State | MA
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Zip | 02481-2135
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Country | US
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Telephone | 617-340-6446
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Fax |
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | SARA FRIEL
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Credential |
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Telephone | 617-340-6446
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number |
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License Number State |
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