Provider Demographics
NPI:1356573349
Name:NORTHSTAR MEDICAL ASSOCIATES LLC
Entity type:Organization
Organization Name:NORTHSTAR MEDICAL ASSOCIATES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER/MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:NASIR
Authorized Official - Middle Name:ALAM
Authorized Official - Last Name:BHATTI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:857-247-8538
Mailing Address - Street 1:40 WILLARD ST
Mailing Address - Street 2:SUITE 103
Mailing Address - City:QUINCY
Mailing Address - State:MA
Mailing Address - Zip Code:02169-1252
Mailing Address - Country:US
Mailing Address - Phone:617-471-0011
Mailing Address - Fax:617-481-1284
Practice Address - Street 1:40 WILLARD ST
Practice Address - Street 2:SUITE 103
Practice Address - City:QUINCY
Practice Address - State:MA
Practice Address - Zip Code:02169-1252
Practice Address - Country:US
Practice Address - Phone:617-471-0011
Practice Address - Fax:617-481-1284
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-08-10
Last Update Date:2017-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA215383261QP2300X
207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary DiseaseGroup - Single Specialty
No261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary CareGroup - Single Specialty