Provider Demographics
NPI:1003507013
Name:COASTAL ORTHOPEDIC ASSOCIATES INC
Entity Type:Organization
Organization Name:COASTAL ORTHOPEDIC ASSOCIATES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COO
Authorized Official - Prefix:
Authorized Official - First Name:KRISTEN
Authorized Official - Middle Name:
Authorized Official - Last Name:CUTLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:978-927-3040
Mailing Address - Street 1:152 CONANT ST STE 301
Mailing Address - Street 2:
Mailing Address - City:BEVERLY
Mailing Address - State:MA
Mailing Address - Zip Code:01915-1659
Mailing Address - Country:US
Mailing Address - Phone:978-927-3040
Mailing Address - Fax:
Practice Address - Street 1:99 CONIFER HILL DR STE 204
Practice Address - Street 2:
Practice Address - City:DANVERS
Practice Address - State:MA
Practice Address - Zip Code:01923-1194
Practice Address - Country:US
Practice Address - Phone:978-927-3040
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-05-19
Last Update Date:2023-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Multi-Specialty