Provider Demographics
NPI:1780807859
Name:INTERNISTS ASSOCIATED
Entity type:Organization
Organization Name:INTERNISTS ASSOCIATED
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SIMON
Authorized Official - Middle Name:L
Authorized Official - Last Name:WEITZMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:781-444-9080
Mailing Address - Street 1:105 CHESTNUT ST
Mailing Address - Street 2:SUITE 26
Mailing Address - City:NEEDHAM
Mailing Address - State:MA
Mailing Address - Zip Code:02492-2599
Mailing Address - Country:US
Mailing Address - Phone:781-444-9080
Mailing Address - Fax:781-455-8924
Practice Address - Street 1:105 CHESTNUT ST
Practice Address - Street 2:SUITE 26
Practice Address - City:NEEDHAM
Practice Address - State:MA
Practice Address - Zip Code:02492-2599
Practice Address - Country:US
Practice Address - Phone:781-444-9080
Practice Address - Fax:781-455-8924
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-10
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAM15636Medicare ID - Type UnspecifiedYATISH PATEL
MAM15636Medicare ID - Type UnspecifiedJACQUELINE FEUER
MAF38473Medicare UPIN
MAA67005Medicare UPIN
MAB98072Medicare UPIN
MAM15636Medicare ID - Type UnspecifiedSIMON WEITZMAN