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General NPI Number Information
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NPI Number | 1588102602
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Entity Type | Organization
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Legal Business Name | NSENT CONGENIAL HEALTHCARE
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Dates
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Enumeration Date | 02/09/2017
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Last Update Date | 09/29/2021
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Provider Practice Location Address
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Address Line | 104 ENDICOTT ST STE 100
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City | DANVERS
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State | MA
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Zip | 01923-3623
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Country | US
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Telephone | 978-745-6601
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Fax |
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Provider Business Mailing Address
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Address Line | 104 ENDICOTT ST STE 100
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City | DANVERS
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State | MA
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Zip | 01923-3623
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Country | US
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Telephone | 978-745-6601
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Fax |
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Authorized Official
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Title or Position | PRACTICE ADMIN
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Name | TERRY O'CALLAGHAN
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Credential |
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Telephone | 603-812-3682
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | PA6024
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License Number State | MA
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Taxonomy #2
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Taxonomy Code | 207Y00000X
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Taxonomy Name | Otolaryngology Physician
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License Number |
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License Number State |
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