Provider Demographics
NPI:1841676905
Name:BOSTON ORTHOPAEDIC URGENT CARE, LLC
Entity type:Organization
Organization Name:BOSTON ORTHOPAEDIC URGENT CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:FRANK
Authorized Official - Middle Name:X
Authorized Official - Last Name:PEDLOW
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD
Authorized Official - Phone:617-236-5893
Mailing Address - Street 1:23 RIDGEWAY LN
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02114-4206
Mailing Address - Country:US
Mailing Address - Phone:617-236-5893
Mailing Address - Fax:
Practice Address - Street 1:23 RIDGEWAY LN
Practice Address - Street 2:
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02114-4206
Practice Address - Country:US
Practice Address - Phone:617-236-5893
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-07-30
Last Update Date:2015-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Multi-Specialty