| NPI | 1104367630 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ASHLEY KOCH CFO 617-562-5359 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208800000X Urology |
| Additional Taxonomies | 207Q00000X Family Medicine |
| 207R00000X Internal Medicine | |
| 207RC0000X Internal Medicine, Cardiovascular Disease | |
| 207RI0011X Internal Medicine, Interventional Cardiology | |
| 207RP1001X Internal Medicine, Pulmonary Disease | |
| 207V00000X Obstetrics & Gynecology | |
| 208600000X Surgery | |
| Enumeration Date | 2017-03-16 |
| Last Update Date | 2020-08-13 |