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General NPI Number Information
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NPI Number | 1689728669
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Entity Type | Organization
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Legal Business Name | ORTHOPEDIC SURGERY, INC
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Dates
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Enumeration Date | 01/23/2007
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Last Update Date | 07/15/2021
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Provider Practice Location Address
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Address Line | 92 MONTVALE AVE SUITE 1400
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City | STONEHAM
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State | MA
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Zip | 02180-3647
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Country | US
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Telephone | 781-279-7040
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Fax | 781-279-8430
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Provider Business Mailing Address
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Address Line | 92 MONTVALE AVE SUITE 1400
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City | STONEHAM
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State | MA
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Zip | 02180-3647
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Country | US
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Telephone | 781-279-7040
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Fax | 781-279-8430
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Authorized Official
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Title or Position | BUSINESS MANAGER
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Name | MAUREEN STANTON
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Credential |
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Telephone | 781-279-7040
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RR0500X
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Taxonomy Name | Rheumatology Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number |
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License Number State |
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