Provider Demographics
NPI:1063680296
Name:NORTHEAST HEALTHCARE SYSTEM
Entity Type:Organization
Organization Name:NORTHEAST HEALTHCARE SYSTEM
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PEDIATRICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:GERALD
Authorized Official - Last Name:ORR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:978-283-5079
Mailing Address - Street 1:10 DONALD RD
Mailing Address - Street 2:
Mailing Address - City:SOUTH HAMILTON
Mailing Address - State:MA
Mailing Address - Zip Code:01982-1506
Mailing Address - Country:US
Mailing Address - Phone:978-468-4646
Mailing Address - Fax:
Practice Address - Street 1:32 LESLIE O JOHNSON RD
Practice Address - Street 2:
Practice Address - City:GLOUCESTER
Practice Address - State:MA
Practice Address - Zip Code:01930-2500
Practice Address - Country:US
Practice Address - Phone:978-281-3901
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-11
Last Update Date:2008-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA262899282NC2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282NC2000XHospitalsGeneral Acute Care HospitalChildren