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General NPI Number Information
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NPI Number | 1447995311
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Entity Type | Organization
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Legal Business Name | NEW ENGLAND BAPTIST SURGERY CENTER LLC
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Dates
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Enumeration Date | 05/04/2022
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Last Update Date | 05/05/2022
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Provider Practice Location Address
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Address Line | 40 ALLIED DR STE 200
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City | DEDHAM
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State | MA
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Zip | 02026-6146
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Country | US
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Telephone | 860-667-9542
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Fax |
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Provider Business Mailing Address
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Address Line | 100 AVON MEADOW LN
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City | AVON
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State | CT
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Zip | 06001-4703
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | DIRECTOR, BUSINESS SYSTEMS
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Name | BRIAN SHIEH
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Credential |
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Telephone | 860-667-9542
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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 |
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License Number State |
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