Provider Demographics
NPI:1568839033
Name:CAMBRIDGE NEUROSURGICAL SPINECARE LLC
Entity Type:Organization
Organization Name:CAMBRIDGE NEUROSURGICAL SPINECARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:RONALD
Authorized Official - Middle Name:K
Authorized Official - Last Name:WARREN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:617-548-3733
Mailing Address - Street 1:725 CONCORD AVE
Mailing Address - Street 2:SUITE 2300
Mailing Address - City:CAMBRIDGE
Mailing Address - State:MA
Mailing Address - Zip Code:02138-1040
Mailing Address - Country:US
Mailing Address - Phone:617-548-3722
Mailing Address - Fax:
Practice Address - Street 1:725 CONCORD AVE
Practice Address - Street 2:SUITE 2300
Practice Address - City:CAMBRIDGE
Practice Address - State:MA
Practice Address - Zip Code:02138-1040
Practice Address - Country:US
Practice Address - Phone:617-548-3722
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-08-31
Last Update Date:2015-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA44013207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological SurgeryGroup - Single Specialty