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General NPI Number Information
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NPI Number | 1255307781
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Entity Type | Individual
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Provider Name | MARK HRYNIEWICH MD
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Gender | Male
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Dates
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Enumeration Date | 02/24/2006
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Last Update Date | 12/11/2018
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Provider Practice Location Address
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Address Line | 225 NEW LANCASTER RD
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City | LEOMINSTER
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State | MA
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Zip | 01453-4958
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Country | US
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Telephone | 978-466-3212
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Fax | 978-534-3581
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Provider Business Mailing Address
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Address Line | 5 NEPONSET ST WOT 2ND FL, STE C203
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City | WORCESTER
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State | MA
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Zip | 01606-2714
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Country | US
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Telephone | 978-466-3212
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Fax | 978-534-3581
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 49755
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License Number State | MA
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