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General NPI Number Information
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NPI Number | 1538110846
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Entity Type | Organization
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Legal Business Name | BEVERLY RADIOLOGY ASSOCIATES, INC.
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Dates
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Enumeration Date | 05/12/2006
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Last Update Date | 06/07/2012
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Provider Practice Location Address
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Address Line | 85 HERRICK ST RADIOLOGY DEPARTMENT
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City | BEVERLY
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State | MA
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Zip | 01915-1776
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Country | US
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Telephone | 978-927-6385
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Fax | 978-927-3534
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Provider Business Mailing Address
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Address Line | 85 HERRICK ST RADIOLOGY DEPARTMENT
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City | BEVERLY
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State | MA
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Zip | 01915-1776
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Country | US
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Telephone | 978-927-6385
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Fax | 978-927-3534
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Authorized Official
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Title or Position | PRESIDENT
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Name | AUGUSTINE O'KEEFFE
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Credential | MD
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Telephone | 978-927-6385
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number |
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License Number State |
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