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General NPI Number Information
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NPI Number | 1487047262
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Entity Type | Organization
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Legal Business Name | NORTHEAST VEIN SPECIALISTS LLC
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Dates
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Enumeration Date | 03/18/2015
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Last Update Date | 03/18/2015
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Provider Practice Location Address
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Address Line | 203 TURNPIKE ST SUITE 125
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City | NORTH ANDOVER
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State | MA
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Zip | 01845-5042
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Country | US
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Telephone | 978-689-2234
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Fax |
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Provider Business Mailing Address
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Address Line | 203 TURNPIKE ST SUITE 125
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City | NORTH ANDOVER
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State | MA
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Zip | 01845-5042
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Country | US
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Telephone | 978-689-2234
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. TIMOTHY JOHN NORTON
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Credential | M.D.
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Telephone | 978-689-2234
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085R0204X
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Taxonomy Name | Vascular & Interventional Radiology Physician
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License Number | 239422
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License Number State | MA
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