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General NPI Number Information
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NPI Number | 1942373691
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Entity Type | Organization
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Legal Business Name | UROLOGY CENTRAL PC
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Dates
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Enumeration Date | 11/17/2006
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Last Update Date | 08/11/2018
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Provider Practice Location Address
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Address Line | 50 MEMORIAL DRIVE SUITE 108
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City | LEOMINSTER
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State | MA
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Zip | 01453
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Country | US
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Telephone | 978-466-2280
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Fax | 978-466-2282
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Provider Business Mailing Address
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Address Line | 50 MEMORIAL DRIVE SUITE 108
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City | LEOMINSTER
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State | MA
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Zip | 01453
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Country | US
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Telephone | 978-466-2280
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Fax | 978-466-2282
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Authorized Official
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Title or Position | OWNER PHYSICIAN
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Name | RONALD G EBB
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Credential | MD
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Telephone | 978-466-2280
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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 | 212873
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License Number State | MA
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