Provider Demographics
NPI:1902383276
Name:WINCHESTER PHYSICIAN ASSOCIATES, INC.
Entity Type:Organization
Organization Name:WINCHESTER PHYSICIAN ASSOCIATES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT, PHYSICIAN SERVICES
Authorized Official - Prefix:
Authorized Official - First Name:CATHARINE
Authorized Official - Middle Name:
Authorized Official - Last Name:ROBERTSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:781-756-2114
Mailing Address - Street 1:41 HIGHLAND AVENUE
Mailing Address - Street 2:
Mailing Address - City:WINCHESTER
Mailing Address - State:MA
Mailing Address - Zip Code:01890
Mailing Address - Country:US
Mailing Address - Phone:781-756-2112
Mailing Address - Fax:781-756-7274
Practice Address - Street 1:100 UNICORN PARK
Practice Address - Street 2:SUITE 102
Practice Address - City:WOBURN
Practice Address - State:MA
Practice Address - Zip Code:01801
Practice Address - Country:US
Practice Address - Phone:781-721-0500
Practice Address - Fax:781-721-5719
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-07-19
Last Update Date:2018-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA3035225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty