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General NPI Number Information
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NPI Number | 1629294061
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Entity Type | Organization
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Legal Business Name | CENTER FOR CONTINENCE CONTROL
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Dates
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Enumeration Date | 04/17/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 150 YORK ST
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City | STOUGHTON
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State | MA
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Zip | 02072-1829
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Country | US
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Telephone | 781-297-1391
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Fax | 781-828-2471
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Provider Business Mailing Address
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Address Line | 1 EDWARD ST
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City | CANTON
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State | MA
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Zip | 02021-2303
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Country | US
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Telephone | 781-828-3533
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Fax | 781-828-2471
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Authorized Official
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Title or Position | OWNER
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Name | ROBERT MIRKIN SCHLESINGER
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Credential | M.D.
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Telephone | 781-828-3533
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208800000X
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Taxonomy Name | Urology Physician
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License Number | 32227
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License Number State | MA
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