Provider Demographics
NPI:1740398734
Name:BOSTON ENDOSCOPY CENTER INC.
Entity Type:Organization
Organization Name:BOSTON ENDOSCOPY CENTER INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:ZALMAN
Authorized Official - Middle Name:MYRON
Authorized Official - Last Name:FALCHUK
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:617-632-8623
Mailing Address - Street 1:175 WORCESTER ST
Mailing Address - Street 2:
Mailing Address - City:WELLESLEY HILLS
Mailing Address - State:MA
Mailing Address - Zip Code:02481-5514
Mailing Address - Country:US
Mailing Address - Phone:617-754-0800
Mailing Address - Fax:617-754-0820
Practice Address - Street 1:175 WORCESTER ST
Practice Address - Street 2:
Practice Address - City:WELLESLEY HILLS
Practice Address - State:MA
Practice Address - Zip Code:02481-5514
Practice Address - Country:US
Practice Address - Phone:617-754-0800
Practice Address - Fax:617-754-0820
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-29
Last Update Date:2010-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QE0800XAmbulatory Health Care FacilitiesClinic/CenterEndoscopy
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA221036Medicare ID - Type Unspecified