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General NPI Number Information
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NPI Number | 1265706964
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Entity Type | Organization
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Legal Business Name | EASTERN AND WESTERN MEDICAL CENTER
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Dates
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Enumeration Date | 02/28/2012
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Last Update Date | 02/28/2012
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Provider Practice Location Address
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Address Line | 381 PARK AVE.
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City | WORCESTER
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State | MA
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Zip | 01610-1026
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Country | US
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Telephone | 508-792-3200
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Fax | 508-792-0400
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Provider Business Mailing Address
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Address Line | 381 PARK AVE.
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City | WORCESTER
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State | MA
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Zip | 01610-1026
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Country | US
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Telephone | 508-792-3200
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Fax | 508-792-0400
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Authorized Official
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Title or Position | MANAGER
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Name | ALAN PERL
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Credential |
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Telephone | 508-792-3200
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 207XX0005X
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Taxonomy Name | Sports Medicine (Orthopaedic Surgery) Physician
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 225700000X
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Taxonomy Name | Massage Therapist
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 171100000X
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Taxonomy Name | Acupuncturist
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License Number |
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License Number State |
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