Provider Demographics
NPI:1679959977
Name:NORTHEAST ORTHOPEDIC ASSOCIATES, INC.
Entity Type:Organization
Organization Name:NORTHEAST ORTHOPEDIC ASSOCIATES, INC.
Other - Org Name:GREATER BOSTON ORTHOPEDIC CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRACTICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:KATE
Authorized Official - Middle Name:D
Authorized Official - Last Name:MCAULAY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:781-461-4543
Mailing Address - Street 1:200 PROVIDENCE HIGHWAY
Mailing Address - Street 2:SUITE 200
Mailing Address - City:DEDHAM
Mailing Address - State:MA
Mailing Address - Zip Code:02026-2021
Mailing Address - Country:US
Mailing Address - Phone:781-461-4543
Mailing Address - Fax:781-326-2030
Practice Address - Street 1:200 PROVIDENCE HWY
Practice Address - Street 2:SUITE 200
Practice Address - City:DEDHAM
Practice Address - State:MA
Practice Address - Zip Code:02026-1881
Practice Address - Country:US
Practice Address - Phone:781-461-4543
Practice Address - Fax:781-326-2030
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-08-10
Last Update Date:2015-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty