Provider Demographics
NPI:1467678433
Name:NORTH SHORE MEDICAL CENTER
Entity Type:Organization
Organization Name:NORTH SHORE MEDICAL CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:TRIAGE CLINICIAN
Authorized Official - Prefix:
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:B
Authorized Official - Last Name:JAY
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:978-354-4550
Mailing Address - Street 1:43 LINDENWOOD RD
Mailing Address - Street 2:
Mailing Address - City:STONEHAM
Mailing Address - State:MA
Mailing Address - Zip Code:02180-2348
Mailing Address - Country:US
Mailing Address - Phone:781-438-7279
Mailing Address - Fax:
Practice Address - Street 1:81 HIGHLAND AVE
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:MA
Practice Address - Zip Code:01970-2714
Practice Address - Country:US
Practice Address - Phone:978-354-4550
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-18
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA205361282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital