MEDICARE: NEW ENGLAND PLASTIC SURGICAL ASSOCIATES, PC

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	208200000X	Plastic Surgery Physician

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	M19078	OTHER	MA	BC BS OF MA

General Provider Information

NPI Number	:	1851336499
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NEW ENGLAND PLASTIC SURGICAL ASSOCIATES, PC

Provider Business Mailing Address
First Line	:	29 CRAFTS ST
Second Line	:	SUITE 370
City	:	NEWTON
State	:	MA
Zip	:	02458-1275
Country	:	US
Telephone Number	:	617-965-9500
Fax Number	:

Provider Business Practice Location Address
First Line	:	29 CRAFTS ST
Second Line	:	SUITE 370
City	:	NEWTON
State	:	MA
Zip	:	02458-1275
Country	:	US
Telephone Number	:	617-969-9500
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	RICHARD SILVERMAN
Credential	:	MD
Telephone Number	:	617-969-9500

Provider Enumeration Date	:	06/18/2006
Last Update Date	:	10/21/2008

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