Provider Demographics
NPI:1922322718
Name:NEW ENGLAND WELLNESS & PAIN MANAGEMENT PC
Entity Type:Organization
Organization Name:NEW ENGLAND WELLNESS & PAIN MANAGEMENT PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:FATHALLA
Authorized Official - Middle Name:M
Authorized Official - Last Name:MASHALI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:781-885-0658
Mailing Address - Street 1:10 CONVERSE PL
Mailing Address - Street 2:4TH FLOOR
Mailing Address - City:WINCHESTER
Mailing Address - State:MA
Mailing Address - Zip Code:01890-2713
Mailing Address - Country:US
Mailing Address - Phone:781-729-0500
Mailing Address - Fax:781-729-0581
Practice Address - Street 1:10 CONVERSE PL
Practice Address - Street 2:4TH FLOOR
Practice Address - City:WINCHESTER
Practice Address - State:MA
Practice Address - Zip Code:01890-2713
Practice Address - Country:US
Practice Address - Phone:781-729-0500
Practice Address - Fax:781-729-0581
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-03-23
Last Update Date:2013-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain MedicineGroup - Multi-Specialty