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General NPI Number Information
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NPI Number | 1316212384
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Entity Type | Organization
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Legal Business Name | NEW ENGLAND HEALTH AND WELLNESS LLC
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Dates
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Enumeration Date | 03/09/2012
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Last Update Date | 05/17/2013
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Provider Practice Location Address
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Address Line | 34 CHELMSFORD ST
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City | CHELMSFORD
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State | MA
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Zip | 01824-3017
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Country | US
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Telephone | 978-244-9355
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Fax | 978-244-9356
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Provider Business Mailing Address
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Address Line | 34 CHELMSFORD ST
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City | CHELMSFORD
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State | MA
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Zip | 01824-3017
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Country | US
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Telephone | 978-244-9355
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Fax | 978-244-9356
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Authorized Official
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Title or Position | PRESIDENT/OWNER
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Name | JOHN P. BRODERICK SR.
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Credential | D. C.
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Telephone | 978-244-9355
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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 |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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