Provider Demographics
NPI:1831131473
Name:WINCHESTER EMERGENCY MEDICAL ASSOCIATES PC
Entity Type:Organization
Organization Name:WINCHESTER EMERGENCY MEDICAL ASSOCIATES PC
Other - Org Name:WINCHESTER EMERGENCY MEDICAL ASSOCIATES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:GREGORY
Authorized Official - Middle Name:
Authorized Official - Last Name:WEISZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:781-756-2000
Mailing Address - Street 1:41 HIGHLAND AVE
Mailing Address - Street 2:
Mailing Address - City:WINCHESTER
Mailing Address - State:MA
Mailing Address - Zip Code:01890-1446
Mailing Address - Country:US
Mailing Address - Phone:781-756-7273
Mailing Address - Fax:781-756-7274
Practice Address - Street 1:41 HIGHLAND AVE
Practice Address - Street 2:
Practice Address - City:WINCHESTER
Practice Address - State:MA
Practice Address - Zip Code:01890-1446
Practice Address - Country:US
Practice Address - Phone:781-756-7273
Practice Address - Fax:781-756-7274
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-11
Last Update Date:2013-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA52545207P00000X
MA219885207P00000X
MA220175207P00000X
MA220753207P00000X
MA227055207P00000X
MA50232207P00000X
MA59953207P00000X
MA75607207P00000X
MA73336207P00000X
MA81882207P00000X
MA160977207P00000X
MA219358207P00000X
MA44256207P00000X
MA49351207P00000X
MA46118207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA9703179Medicaid
MA9703179Medicaid