Provider Demographics
NPI:1326898503
Name:ORTHOPEDIC AND SPINE SPECIALISTS OF MA PLLC
Entity Type:Organization
Organization Name:ORTHOPEDIC AND SPINE SPECIALISTS OF MA PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ASSISTANT ADMIN
Authorized Official - Prefix:
Authorized Official - First Name:CARIANNE
Authorized Official - Middle Name:
Authorized Official - Last Name:YANTZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:561-507-0800
Mailing Address - Street 1:11 BEACON ST STE 800
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02108-3021
Mailing Address - Country:US
Mailing Address - Phone:561-507-0800
Mailing Address - Fax:561-600-8705
Practice Address - Street 1:11 BEACON ST STE 800
Practice Address - Street 2:
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02108-3021
Practice Address - Country:US
Practice Address - Phone:561-507-0800
Practice Address - Fax:561-600-8705
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-03-22
Last Update Date:2024-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207XS0117XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryOrthopaedic Surgery of the SpineGroup - Multi-Specialty
No207XX0801XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryOrthopaedic TraumaGroup - Multi-Specialty