Provider Demographics
NPI:1689728669
Name:ORTHOPEDIC SURGERY, INC
Entity Type:Organization
Organization Name:ORTHOPEDIC SURGERY, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:MAUREEN
Authorized Official - Middle Name:
Authorized Official - Last Name:STANTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:781-279-7040
Mailing Address - Street 1:92 MONTVALE AVE
Mailing Address - Street 2:SUITE 1400
Mailing Address - City:STONEHAM
Mailing Address - State:MA
Mailing Address - Zip Code:02180-3647
Mailing Address - Country:US
Mailing Address - Phone:781-279-7040
Mailing Address - Fax:781-279-8430
Practice Address - Street 1:92 MONTVALE AVE
Practice Address - Street 2:SUITE 1400
Practice Address - City:STONEHAM
Practice Address - State:MA
Practice Address - Zip Code:02180-3647
Practice Address - Country:US
Practice Address - Phone:781-279-7040
Practice Address - Fax:781-279-8430
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-23
Last Update Date:2021-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty
No207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAM12363Medicare UPIN
MA1071490001Medicare NSC