Provider Demographics
NPI:1114232261
Name:RADIOLOGY ASSOCIATES OF NORWOOD INC
Entity Type:Organization
Organization Name:RADIOLOGY ASSOCIATES OF NORWOOD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ALBERT
Authorized Official - Middle Name:L
Authorized Official - Last Name:INTERRANTE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:781-762-5595
Mailing Address - Street 1:825 WASHINGTON ST
Mailing Address - Street 2:SUITE 215
Mailing Address - City:NORWOOD
Mailing Address - State:MA
Mailing Address - Zip Code:02062-3441
Mailing Address - Country:US
Mailing Address - Phone:781-762-8010
Mailing Address - Fax:781-762-7753
Practice Address - Street 1:800 WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:NORWOOD
Practice Address - State:MA
Practice Address - Zip Code:02062-3487
Practice Address - Country:US
Practice Address - Phone:781-278-6355
Practice Address - Fax:781-255-0882
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-08-13
Last Update Date:2010-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA293D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes293D00000XLaboratoriesPhysiological Laboratory
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA9704078Medicaid
MAM10836OtherBLUE SHIELD OF MASSACHUSETTS
MAM10836Medicare PIN