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NPI Code Detail

MEDICARE: ANAESTHESIA ASSOCIATES OF MASSACHUSETTS, P.C.

MEDICARE: ANAESTHESIA ASSOCIATES OF MASSACHUSETTS, P.C.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207L00000XAnesthesiology PhysicianMA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1336192921
Entity Type Code : Organization
Provider Name (Legal Business Name) : ANAESTHESIA ASSOCIATES OF MASSACHUSETTS, P.C.
Provider Business Mailing Address
First Line : PO BOX 414422
Second Line :
City : BOSTON
State : MA
Zip : 02241-4422
Country : US
Telephone Number : 781-407-7713
Fax Number : 781-407-0998
Provider Business Practice Location Address
First Line : 148 CHESTNUT ST
Second Line :
City : NEEDHAM
State : MA
Zip : 02492-2505
Country : US
Telephone Number : 781-453-5289
Fax Number :
Authorized Official
Title or Position : COO
Name : MR. ROBERT D. MCIVOR
Credential :
Telephone Number : 781-407-7713
Provider Enumeration Date : 05/18/2006
Last Update Date : 08/22/2020

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