Provider Demographics
NPI:1346559333
Name:HIGHLAND SURGICAL ASSOCIATES LLC
Entity Type:Organization
Organization Name:HIGHLAND SURGICAL ASSOCIATES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD
Authorized Official - Prefix:DR
Authorized Official - First Name:GREGORY
Authorized Official - Middle Name:J
Authorized Official - Last Name:KECHEJIAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:617-696-0660
Mailing Address - Street 1:PO BOX 86
Mailing Address - Street 2:
Mailing Address - City:HINGHAM
Mailing Address - State:MA
Mailing Address - Zip Code:02043-0086
Mailing Address - Country:US
Mailing Address - Phone:781-749-9071
Mailing Address - Fax:781-749-2133
Practice Address - Street 1:100 HIGHLAND ST
Practice Address - Street 2:STE 222
Practice Address - City:MILTON
Practice Address - State:MA
Practice Address - Zip Code:02186-3881
Practice Address - Country:US
Practice Address - Phone:617-696-0660
Practice Address - Fax:617-696-6655
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-09-24
Last Update Date:2010-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Multi-Specialty
No2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular SurgeryGroup - Multi-Specialty