Provider Demographics
NPI:1740905876
Name:NEWTON WELLESLEY AMBULATORY SERVICES
Entity type:Organization
Organization Name:NEWTON WELLESLEY AMBULATORY SERVICES
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:SENIOR VP FINANCE
Authorized Official - Prefix:
Authorized Official - First Name:VINCENT
Authorized Official - Middle Name:
Authorized Official - Last Name:MCDERMOTT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:617-243-6381
Mailing Address - Street 1:978 WORCESTER ST
Mailing Address - Street 2:
Mailing Address - City:WELLESLEY
Mailing Address - State:MA
Mailing Address - Zip Code:02482-3709
Mailing Address - Country:US
Mailing Address - Phone:617-219-1280
Mailing Address - Fax:617-219-1281
Practice Address - Street 1:978 WORCESTER ST
Practice Address - Street 2:
Practice Address - City:WELLESLEY
Practice Address - State:MA
Practice Address - Zip Code:02482-3709
Practice Address - Country:US
Practice Address - Phone:617-219-1280
Practice Address - Fax:617-219-1281
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MASS GENERAL BRIGHAM INCORPORATED
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2022-10-11
Last Update Date:2023-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies