Provider Demographics
NPI:1629475736
Name:NEW ENGLAND ORTHOPEDIC SPECIALISTS, LLC
Entity Type:Organization
Organization Name:NEW ENGLAND ORTHOPEDIC SPECIALISTS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:DOUGLAS
Authorized Official - Middle Name:
Authorized Official - Last Name:HALSTED
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:978-531-0800
Mailing Address - Street 1:4 CENTENNIAL DR
Mailing Address - Street 2:SUITE 201
Mailing Address - City:PEABODY
Mailing Address - State:MA
Mailing Address - Zip Code:01960-7935
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4 CENTENNIAL DR
Practice Address - Street 2:SUITE 201
Practice Address - City:PEABODY
Practice Address - State:MA
Practice Address - Zip Code:01960-7935
Practice Address - Country:US
Practice Address - Phone:978-531-0800
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-12-04
Last Update Date:2014-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA9725547Medicaid