Provider Demographics
NPI:1427383645
Name:EMERSON PRACTICE ASSOCIATES II, INC.
Entity Type:Organization
Organization Name:EMERSON PRACTICE ASSOCIATES II, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SR. DIRECTOR FINANCE
Authorized Official - Prefix:
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:T
Authorized Official - Last Name:KOSOWICZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:603-393-8256
Mailing Address - Street 1:133 OLD ROAD TO 9 ACRE COR
Mailing Address - Street 2:
Mailing Address - City:CONCORD
Mailing Address - State:MA
Mailing Address - Zip Code:01742-4159
Mailing Address - Country:US
Mailing Address - Phone:978-287-3321
Mailing Address - Fax:978-287-3102
Practice Address - Street 1:133 OLD ROAD TO 9 ACRE COR
Practice Address - Street 2:
Practice Address - City:CONCORD
Practice Address - State:MA
Practice Address - Zip Code:01742-4159
Practice Address - Country:US
Practice Address - Phone:978-287-3234
Practice Address - Fax:978-287-3102
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:EMERSON HEALTH SYSTEM
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2009-10-06
Last Update Date:2021-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA207RC0000X, 207RG0100X, 207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Multi-Specialty
No207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterologyGroup - Multi-Specialty