Provider Demographics
NPI:1942654850
Name:NEW ENGLAND CONSULTANTS IN GASTROENTEROLOGY AND HEPATOLOGY PC
Entity Type:Organization
Organization Name:NEW ENGLAND CONSULTANTS IN GASTROENTEROLOGY AND HEPATOLOGY PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:PEGGY
Authorized Official - Middle Name:
Authorized Official - Last Name:BOWER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:508-872-0508
Mailing Address - Street 1:43 LINCOLN ST
Mailing Address - Street 2:
Mailing Address - City:FRAMINGHAM
Mailing Address - State:MA
Mailing Address - Zip Code:01702-8205
Mailing Address - Country:US
Mailing Address - Phone:508-872-0508
Mailing Address - Fax:508-872-0588
Practice Address - Street 1:43 LINCOLN ST
Practice Address - Street 2:
Practice Address - City:FRAMINGHAM
Practice Address - State:MA
Practice Address - Zip Code:01702-8205
Practice Address - Country:US
Practice Address - Phone:508-872-0508
Practice Address - Fax:508-872-0588
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-04-17
Last Update Date:2016-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA230294207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA110076289AMedicaid