Provider Demographics
NPI:1801215439
Name:NASHOBA SURGICAL ASSOCIATES
Entity Type:Organization
Organization Name:NASHOBA SURGICAL ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:KENT
Authorized Official - Middle Name:
Authorized Official - Last Name:GREENWOOD
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:978-345-0050
Mailing Address - Street 1:104 WHALON ST
Mailing Address - Street 2:SUITE 1D
Mailing Address - City:FITCHBURG
Mailing Address - State:MA
Mailing Address - Zip Code:01420-7128
Mailing Address - Country:US
Mailing Address - Phone:978-345-0050
Mailing Address - Fax:
Practice Address - Street 1:104 WHALON ST
Practice Address - Street 2:SUITE 1D
Practice Address - City:FITCHBURG
Practice Address - State:MA
Practice Address - Zip Code:01420-7128
Practice Address - Country:US
Practice Address - Phone:978-345-0050
Practice Address - Fax:978-345-0064
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-04-10
Last Update Date:2014-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA74865208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty