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General NPI Number Information
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NPI Number | 1356585145
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Entity Type | Organization
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Legal Business Name | NORTHEAST PLASTIC SURGERY
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Dates
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Enumeration Date | 04/24/2009
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Last Update Date | 04/24/2009
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Provider Practice Location Address
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Address Line | 15 VILLAGE SQ
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City | CHELMSFORD
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State | MA
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Zip | 01824-2712
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Country | US
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Telephone | 978-256-7697
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Fax |
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Provider Business Mailing Address
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Address Line | 15 VILLAGE SQ
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City | CHELMSFORD
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State | MA
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Zip | 01824-2712
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Country | US
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Telephone | 978-256-7697
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Fax |
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Authorized Official
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Title or Position | BILLING MANAGER
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Name | MRS. BARBARA ZURAWSKI
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Credential | CPC
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Telephone | 978-256-7699
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QA1903X
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Taxonomy Name | Ambulatory Surgical Clinic/Center
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License Number | 204149
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License Number State | ME
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