Provider Demographics
NPI:1346367661
Name:NATICK SURGICAL ASSOCIATES INC.
Entity Type:Organization
Organization Name:NATICK SURGICAL ASSOCIATES INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:H
Authorized Official - Last Name:FRAGER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:508-653-3246
Mailing Address - Street 1:67 UNION ST
Mailing Address - Street 2:SUITE 203A
Mailing Address - City:NATICK
Mailing Address - State:MA
Mailing Address - Zip Code:01760-7700
Mailing Address - Country:US
Mailing Address - Phone:508-653-3246
Mailing Address - Fax:508-655-7209
Practice Address - Street 1:67 UNION ST
Practice Address - Street 2:SUITE 203A
Practice Address - City:NATICK
Practice Address - State:MA
Practice Address - Zip Code:01760-7700
Practice Address - Country:US
Practice Address - Phone:508-653-3246
Practice Address - Fax:508-655-7209
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-23
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA9745092Medicaid
MAM11246OtherBLUE CROSS
MA701094OtherTUFTS
MAM11246Medicare ID - Type Unspecified