Provider Demographics
NPI:1497817621
Name:WELLESLEY WOMEN'S CARE, PC
Entity Type:Organization
Organization Name:WELLESLEY WOMEN'S CARE, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:L
Authorized Official - Last Name:BEATTY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:617-965-7800
Mailing Address - Street 1:2000 WASHINGTON STREET
Mailing Address - Street 2:SUITE 764
Mailing Address - City:NEWTON
Mailing Address - State:MA
Mailing Address - Zip Code:02462-1628
Mailing Address - Country:US
Mailing Address - Phone:617-965-7800
Mailing Address - Fax:617-965-4581
Practice Address - Street 1:2000 WASHINGTON STREET
Practice Address - Street 2:SUITE 764
Practice Address - City:NEWTON
Practice Address - State:MA
Practice Address - Zip Code:02462-1628
Practice Address - Country:US
Practice Address - Phone:617-965-7800
Practice Address - Fax:617-965-4581
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-14
Last Update Date:2008-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA469742OtherAETNA USHEALTHCARE
MA9701061Medicaid
MAM15738OtherBC BS
MAM15738OtherBC BS