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General NPI Number Information
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NPI Number | 1376553693
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Entity Type | Organization
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Legal Business Name | WACHUSETT EMERGENCY PHYSICIANS, PC
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Dates
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Enumeration Date | 08/09/2006
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Last Update Date | 03/16/2011
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Provider Practice Location Address
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Address Line | 60 HOSPITAL RD
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City | LEOMINSTER
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State | MA
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Zip | 01453-2205
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Country | US
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Telephone | 978-466-2994
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Fax | 978-466-2993
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Provider Business Mailing Address
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Address Line | 60 HOSPITAL RD
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City | LEOMINSTER
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State | MA
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Zip | 01453-2205
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Country | US
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Telephone | 978-466-2994
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Fax | 978-466-2993
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Authorized Official
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Title or Position | PRESIDENT
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Name | BONNIE RYAN
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Credential | MD
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Telephone | 978-466-2428
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number |
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License Number State |
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