Provider Demographics
NPI:1073720769
Name:MIDDLESEX SURGICAL ASSOCIATES INC
Entity Type:Organization
Organization Name:MIDDLESEX SURGICAL ASSOCIATES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:L
Authorized Official - Last Name:BRECKWOLDT
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:781-729-2020
Mailing Address - Street 1:955 MAIN ST
Mailing Address - Street 2:SUITE G2A
Mailing Address - City:WINCHESTER
Mailing Address - State:MA
Mailing Address - Zip Code:01890-1961
Mailing Address - Country:US
Mailing Address - Phone:781-729-2020
Mailing Address - Fax:781-729-6846
Practice Address - Street 1:955 MAIN ST
Practice Address - Street 2:SUITE G2A
Practice Address - City:WINCHESTER
Practice Address - State:MA
Practice Address - Zip Code:01890-1961
Practice Address - Country:US
Practice Address - Phone:781-729-2020
Practice Address - Fax:781-729-6846
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-16
Last Update Date:2011-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty