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General NPI Number Information
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NPI Number | 1376588004
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Entity Type | Organization
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Legal Business Name | BOSTON ARTHRITIS & SPINAL SURGERY, P.C.
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Dates
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Enumeration Date | 06/17/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 235 CYPRESS ST SUITE 200
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City | BROOKLINE
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State | MA
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Zip | 02445-6776
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Country | US
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Telephone | 617-730-9814
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Fax | 617-730-9819
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Provider Business Mailing Address
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Address Line | 235 CYPRESS ST SUITE 200
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City | BROOKLINE
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State | MA
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Zip | 02445-6776
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Country | US
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Telephone | 617-730-9814
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Fax | 617-730-9819
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Authorized Official
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Title or Position | PRACTICE ADMINISTRATOR
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Name | LAURA DETOMA SWANSON
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Credential |
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Telephone | 617-730-9814
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207XS0117X
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Taxonomy Name | Orthopaedic Surgery of the Spine Physician
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License Number | 80434
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License Number State | MA
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