Provider Demographics
NPI:1467441923
Name:ORTHOPAEDICS NORTHEAST, P.C.
Entity Type:Organization
Organization Name:ORTHOPAEDICS NORTHEAST, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:JILL
Authorized Official - Middle Name:
Authorized Official - Last Name:LEAHY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:978-327-6561
Mailing Address - Street 1:29 STILES RD
Mailing Address - Street 2:SUITE 102
Mailing Address - City:SALEM
Mailing Address - State:NH
Mailing Address - Zip Code:03079-5802
Mailing Address - Country:US
Mailing Address - Phone:603-898-2220
Mailing Address - Fax:603-890-6378
Practice Address - Street 1:29 STILES RD
Practice Address - Street 2:SUITE 102
Practice Address - City:SALEM
Practice Address - State:NH
Practice Address - Zip Code:03079-2859
Practice Address - Country:US
Practice Address - Phone:603-898-2220
Practice Address - Fax:603-890-6378
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-10-18
Last Update Date:2017-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Multi-Specialty
No207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatologyGroup - Multi-Specialty
No207XS0117XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryOrthopaedic Surgery of the SpineGroup - Multi-Specialty
No208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Multi-Specialty
No213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH3096693Medicaid
NHRE6729Medicare UPIN
NH0389230002Medicare NSC