Provider Demographics
NPI:1811950603
Name:NASHOBA SURGICAL ASSOCIATES, INC.
Entity type:Organization
Organization Name:NASHOBA SURGICAL ASSOCIATES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:KENT
Authorized Official - Middle Name:S
Authorized Official - Last Name:GREENWOOD
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:978-537-6151
Mailing Address - Street 1:104 WHALON STREET
Mailing Address - Street 2:SUITE 1-D
Mailing Address - City:FITCHBURG
Mailing Address - State:MA
Mailing Address - Zip Code:01420
Mailing Address - Country:US
Mailing Address - Phone:978-345-0050
Mailing Address - Fax:978-345-0064
Practice Address - Street 1:104 WHALON STREET
Practice Address - Street 2:SUITE 1-D
Practice Address - City:FITCHBURG
Practice Address - State:MA
Practice Address - Zip Code:01420
Practice Address - Country:US
Practice Address - Phone:978-345-0050
Practice Address - Fax:978-345-0064
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-11
Last Update Date:2009-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA3096378Medicaid
801508OtherHARVARD PILGRIM
074865OtherTUFTS
074865OtherTUFTS
F29919Medicare UPIN
MA3096378Medicaid