Provider Demographics
NPI:1629139472
Name:UNIVERSITY ORTHOPEDICS OF BOSTON
Entity Type:Organization
Organization Name:UNIVERSITY ORTHOPEDICS OF BOSTON
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:MEAGAN
Authorized Official - Middle Name:
Authorized Official - Last Name:WOOD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:617-796-9922
Mailing Address - Street 1:2000 WASHINGTON ST
Mailing Address - Street 2:SUITE 544
Mailing Address - City:NEWTON
Mailing Address - State:MA
Mailing Address - Zip Code:02462-1650
Mailing Address - Country:US
Mailing Address - Phone:617-796-9922
Mailing Address - Fax:617-796-9923
Practice Address - Street 1:2000 WASHINGTON ST
Practice Address - Street 2:SUITE 544
Practice Address - City:NEWTON
Practice Address - State:MA
Practice Address - Zip Code:02462-1650
Practice Address - Country:US
Practice Address - Phone:617-796-9922
Practice Address - Fax:617-796-9923
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-13
Last Update Date:2008-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAF24634Medicare UPIN