MEDICARE: BOSTON ARTHRITIS & SPINAL SURGERY, 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
1	207XS0117X	Orthopaedic Surgery of the Spine Physician	80434	MA

Other Identifiers

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

General Provider Information

NPI Number	:	1376588004
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BOSTON ARTHRITIS & SPINAL SURGERY, P.C.

Provider Business Mailing Address
First Line	:	235 CYPRESS ST
Second Line	:	SUITE 200
City	:	BROOKLINE
State	:	MA
Zip	:	02445-6776
Country	:	US
Telephone Number	:	617-730-9814
Fax Number	:	617-730-9819

Provider Business Practice Location Address
First Line	:	235 CYPRESS ST
Second Line	:	SUITE 200
City	:	BROOKLINE
State	:	MA
Zip	:	02445-6776
Country	:	US
Telephone Number	:	617-730-9814
Fax Number	:	617-730-9819

Authorized Official
Title or Position	:	PRACTICE ADMINISTRATOR
Name	:	LAURA DETOMA SWANSON
Credential	:
Telephone Number	:	617-730-9814

Provider Enumeration Date	:	06/17/2006
Last Update Date	:	08/22/2020

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