Provider Demographics
NPI:1881121630
Name:WINCHESTER PHYSICIAN ASSOCIATES INC
Entity type:Organization
Organization Name:WINCHESTER PHYSICIAN ASSOCIATES INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:EILEEN
Authorized Official - Middle Name:
Authorized Official - Last Name:WILLS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:781-756-7273
Mailing Address - Street 1:3 WOODLAND ROAD
Mailing Address - Street 2:SUITE 309
Mailing Address - City:STONEHAM
Mailing Address - State:MA
Mailing Address - Zip Code:02180
Mailing Address - Country:US
Mailing Address - Phone:781-665-4542
Mailing Address - Fax:781-665-0177
Practice Address - Street 1:3 WOODLAND ROAD
Practice Address - Street 2:SUITE 309
Practice Address - City:STONEHAM
Practice Address - State:MA
Practice Address - Zip Code:02180
Practice Address - Country:US
Practice Address - Phone:781-665-4542
Practice Address - Fax:781-665-0177
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:WINCHESTER PHYSICIAN ASSOCIATES INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2017-05-11
Last Update Date:2017-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty