Provider Demographics
NPI:1700928934
Name:SURGICAL ASSOCIATES OF CONCORD PC
Entity Type:Organization
Organization Name:SURGICAL ASSOCIATES OF CONCORD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ANDREA
Authorized Official - Middle Name:
Authorized Official - Last Name:RESCINITI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:978-371-7433
Mailing Address - Street 1:131 OLD ROAD TO 9 ACRE COR
Mailing Address - Street 2:SUITE 435
Mailing Address - City:CONCORD
Mailing Address - State:MA
Mailing Address - Zip Code:01742-4181
Mailing Address - Country:US
Mailing Address - Phone:978-371-7433
Mailing Address - Fax:978-371-7431
Practice Address - Street 1:131 OLD ROAD TO 9 ACRE COR
Practice Address - Street 2:SUITE 435
Practice Address - City:CONCORD
Practice Address - State:MA
Practice Address - Zip Code:01742-4181
Practice Address - Country:US
Practice Address - Phone:978-371-7433
Practice Address - Fax:978-371-7431
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-13
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA3034747Medicaid
MAA59319Medicare UPIN
MAJ07370Medicare ID - Type Unspecified