Provider Demographics
NPI:1972888576
Name:NORTHEAST RADIOLOGY ASSOCIATES, LLP
Entity Type:Organization
Organization Name:NORTHEAST RADIOLOGY ASSOCIATES, LLP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:BRUCE
Authorized Official - Middle Name:E
Authorized Official - Last Name:COOPER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:978-463-1120
Mailing Address - Street 1:25 HIGHLAND AVE
Mailing Address - Street 2:
Mailing Address - City:NEWBURYPORT
Mailing Address - State:MA
Mailing Address - Zip Code:01950-3867
Mailing Address - Country:US
Mailing Address - Phone:978-463-1120
Mailing Address - Fax:978-463-1171
Practice Address - Street 1:516 PURITAN RD
Practice Address - Street 2:C/O BRUCE E. COOPER, MD
Practice Address - City:SWAMPSCOTT
Practice Address - State:MA
Practice Address - Zip Code:01907-2820
Practice Address - Country:US
Practice Address - Phone:978-463-1120
Practice Address - Fax:978-463-1171
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-10-14
Last Update Date:2011-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Single Specialty