Provider Demographics
NPI:1952636086
Name:NATIONAL GRID
Entity Type:Organization
Organization Name:NATIONAL GRID
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:STAFF PHYSICIAN
Authorized Official - Prefix:MR
Authorized Official - First Name:ARNOLD
Authorized Official - Middle Name:
Authorized Official - Last Name:SOSLOW
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:508-389-2506
Mailing Address - Street 1:25 RESEARCH DR
Mailing Address - Street 2:
Mailing Address - City:WESTBOROUGH
Mailing Address - State:MA
Mailing Address - Zip Code:01582-0001
Mailing Address - Country:US
Mailing Address - Phone:508-389-2506
Mailing Address - Fax:508-389-4432
Practice Address - Street 1:25 RESEARCH DR
Practice Address - Street 2:
Practice Address - City:WESTBOROUGH
Practice Address - State:MA
Practice Address - Zip Code:01582-0001
Practice Address - Country:US
Practice Address - Phone:508-389-2506
Practice Address - Fax:508-389-4432
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-10-07
Last Update Date:2009-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA34663171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171M00000XOther Service ProvidersCase Manager/Care CoordinatorGroup - Single Specialty