Provider Demographics
NPI:1437288529
Name:CAMBRIDGE CARDIOVASCULAR ULTRASOUND, INC
Entity Type:Organization
Organization Name:CAMBRIDGE CARDIOVASCULAR ULTRASOUND, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:TREASURER
Authorized Official - Prefix:
Authorized Official - First Name:BRENDAN
Authorized Official - Middle Name:
Authorized Official - Last Name:CARROLL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:781-820-0506
Mailing Address - Street 1:174 E EMERSON ST
Mailing Address - Street 2:
Mailing Address - City:MELROSE
Mailing Address - State:MA
Mailing Address - Zip Code:02176-3535
Mailing Address - Country:US
Mailing Address - Phone:781-820-0506
Mailing Address - Fax:781-826-0054
Practice Address - Street 1:1493 CAMBRIDGE ST
Practice Address - Street 2:
Practice Address - City:CAMBRIDGE
Practice Address - State:MA
Practice Address - Zip Code:02139-1047
Practice Address - Country:US
Practice Address - Phone:781-820-0506
Practice Address - Fax:781-826-0054
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-05
Last Update Date:2020-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes246W00000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, CardiologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA040469OtherBLUE CROSS BLUE SHIELD
MA3400039OtherUNITED HEALTHCARE
MA327107Medicare PIN