Provider Demographics
NPI:1225074735
Name:UROLOGY ASSOCIATES OF ESSEX NORTH INC
Entity Type:Organization
Organization Name:UROLOGY ASSOCIATES OF ESSEX NORTH INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:DONNA
Authorized Official - Middle Name:
Authorized Official - Last Name:CARDARELLI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:978-372-7751
Mailing Address - Street 1:288 GROVELAND ST
Mailing Address - Street 2:
Mailing Address - City:HAVERHILL
Mailing Address - State:MA
Mailing Address - Zip Code:01830-6669
Mailing Address - Country:US
Mailing Address - Phone:978-372-7751
Mailing Address - Fax:978-372-8534
Practice Address - Street 1:288 GROVELAND ST
Practice Address - Street 2:
Practice Address - City:HAVERHILL
Practice Address - State:MA
Practice Address - Zip Code:01830-6669
Practice Address - Country:US
Practice Address - Phone:978-372-7751
Practice Address - Fax:978-372-8534
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-22
Last Update Date:2008-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208800000XAllopathic & Osteopathic PhysiciansUrologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA600312OtherTUFTS
89730OtherUS HEALTHCARE
MA50586OtherFALLON
NH99903083OtherMEDICAID
MA9700447Medicaid
M11611OtherBCBS
MA0008589OtherNEIGHBORHOOD HEALTH PLAN
MACA3836Medicare PIN
MA1225074735Medicare PIN
MA0008589OtherNEIGHBORHOOD HEALTH PLAN