Provider Demographics
NPI:1841321718
Name:MOUNT AUBURN SURGICAL ASSOCIATES, PC
Entity type:Organization
Organization Name:MOUNT AUBURN SURGICAL ASSOCIATES, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:JUDITH
Authorized Official - Middle Name:A
Authorized Official - Last Name:CORREGGIO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:617-868-7456
Mailing Address - Street 1:300 MT AUBURN ST
Mailing Address - Street 2:SUITE 407
Mailing Address - City:CAMBRIDGE
Mailing Address - State:MA
Mailing Address - Zip Code:02138
Mailing Address - Country:US
Mailing Address - Phone:617-868-7456
Mailing Address - Fax:617-868-9243
Practice Address - Street 1:300 MT AUBURN ST
Practice Address - Street 2:SUITE 407 ASSOCIATED SURGEONS PC
Practice Address - City:CAMBRIDGE
Practice Address - State:MA
Practice Address - Zip Code:02138
Practice Address - Country:US
Practice Address - Phone:617-868-7456
Practice Address - Fax:617-868-9243
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-09
Last Update Date:2017-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Multi-Specialty
No2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular SurgeryGroup - Multi-Specialty