=====================================================
General NPI Number Information
=====================================================
NPI Number | 1730284043
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | ALL ABOUT WOMEN SPECIALISTS IN OB GYN PC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/13/2006
-----------------------------------------------------
Last Update Date | 06/10/2008
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 35 LINCOLN STREET STE 1
-----------------------------------------------------
City | FRAMINGHAM
-----------------------------------------------------
State | MA
-----------------------------------------------------
Zip | 01702
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 508-620-9800
-----------------------------------------------------
Fax | 508-665-6729
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 35 LINCOLN STREET STE 1
-----------------------------------------------------
City | FRAMINGHAM
-----------------------------------------------------
State | MA
-----------------------------------------------------
Zip | 01702
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 508-620-9800
-----------------------------------------------------
Fax | 508-665-6729
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT
-----------------------------------------------------
Name | MARY C BETHONEY
-----------------------------------------------------
Credential | MD
-----------------------------------------------------
Telephone | 508-620-9800
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207V00000X
-----------------------------------------------------
Taxonomy Name | Obstetrics & Gynecology Physician
-----------------------------------------------------
License Number | 155687
-----------------------------------------------------
License Number State | MA
-----------------------------------------------------