Provider Demographics
NPI:1386820678
Name:NEW ENGLAND PAIN ASSOCIATES
Entity Type:Organization
Organization Name:NEW ENGLAND PAIN ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:FATHALLA
Authorized Official - Middle Name:
Authorized Official - Last Name:MASHALI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:401-490-2130
Mailing Address - Street 1:42 HEMINGWAY DR
Mailing Address - Street 2:
Mailing Address - City:RIVERSIDE
Mailing Address - State:RI
Mailing Address - Zip Code:02915-2224
Mailing Address - Country:US
Mailing Address - Phone:401-490-2130
Mailing Address - Fax:401-435-2483
Practice Address - Street 1:747 MAIN ST
Practice Address - Street 2:STE. 201
Practice Address - City:CONCORD
Practice Address - State:MA
Practice Address - Zip Code:01742-3302
Practice Address - Country:US
Practice Address - Phone:978-371-0900
Practice Address - Fax:978-371-0915
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-16
Last Update Date:2008-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA90934OtherFALLON
MA642221OtherTUFTS
MA909529OtherHPHC
MA909529OtherHPHC