Provider Demographics
NPI:1497753958
Name:NEW ENGLAND GASTROENTEROLOGY ASSOCIATES, PC
Entity Type:Organization
Organization Name:NEW ENGLAND GASTROENTEROLOGY ASSOCIATES, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:PETER
Authorized Official - Middle Name:E
Authorized Official - Last Name:KRIMS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:508-831-0708
Mailing Address - Street 1:100 CENTRAL ST
Mailing Address - Street 2:4TH FLOOR
Mailing Address - City:WORCESTER
Mailing Address - State:MA
Mailing Address - Zip Code:01608-1209
Mailing Address - Country:US
Mailing Address - Phone:508-831-6708
Mailing Address - Fax:508-831-0272
Practice Address - Street 1:100 CENTRAL ST
Practice Address - Street 2:4TH FLOOR
Practice Address - City:WORCESTER
Practice Address - State:MA
Practice Address - Zip Code:01608-1209
Practice Address - Country:US
Practice Address - Phone:508-831-6708
Practice Address - Fax:508-831-0272
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-07-08
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA9705848Medicaid
MA9705848Medicaid