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General NPI Number Information
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NPI Number | 1356324057
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Entity Type | Organization
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Legal Business Name | PLYMOUTH OB-GYN ASSOCIATES INC
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Dates
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Enumeration Date | 11/28/2005
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 101 LONG POND ROAD SUITE 101
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City | PLYMOUTH
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State | MA
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Zip | 02360
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Country | US
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Telephone | 508-746-1434
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Fax | 508-746-2209
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Provider Business Mailing Address
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Address Line | 101 LONG POND ROAD SUITE 101
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City | PLYMOUTH
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State | MA
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Zip | 02360
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Country | US
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Telephone | 508-746-1434
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Fax | 508-746-2209
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. JULIEANN CORSINI
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Credential | MD
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Telephone | 508-746-1434
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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 | 76977
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License Number State | MA
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