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General NPI Number Information
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NPI Number | 1427041268
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Entity Type | Organization
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Legal Business Name | BEVERLY ANESTHESIA ASSOCIATES, INC.
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Dates
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Enumeration Date | 08/26/2005
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Last Update Date | 08/04/2020
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Provider Practice Location Address
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Address Line | 480 MAPLE ST SUITE C233A
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City | DANVERS
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State | MA
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Zip | 01923-4065
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Country | US
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Telephone | 978-304-8690
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Fax | 978-304-8697
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Provider Business Mailing Address
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Address Line | 480 MAPLE ST SUITE C233A
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City | DANVERS
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State | MA
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Zip | 01923-4065
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Country | US
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Telephone | 978-304-8690
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Fax | 978-304-8697
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | JANICE E REYNOLDS
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Credential |
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Telephone | 978-304-8690
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207LP2900X
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Taxonomy Name | Pain Medicine (Anesthesiology) Physician
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License Number |
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License Number State | MA
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Taxonomy #2
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number |
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License Number State | MA
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