Organization
SOUTH SHORE MEDICAL CENTER, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JACLYN VALANZOLA (CREDENTIALING SUPERVISOR)
(781) 681-0384
Entity
Organization
Contact information
Practice address
143 LONGWATER DR, NORWELL, MA 02061-1683
(781) 878-5200
Mailing address
141 LONGWATER DR, NORWELL, MA 02061-1632
(781) 792-4136
Taxonomy
Speciality
Code
Description
License number
State
207KA0200X
Allergy Physician
—
—
207N00000X
Dermatology Physician
Primary
—
—
207Q00000X
Family Medicine Physician
—
—
207R00000X
Internal Medicine Physician
—
—
207V00000X
Obstetrics & Gynecology Physician
—
—
207X00000X
Orthopaedic Surgery Physician
—
—
208000000X
Pediatrics Physician
—
—
208800000X
Urology Physician
—
—
208D00000X
General Practice Physician
—
—
213E00000X
Podiatrist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1669411856
—
MA
Enumeration date
06/06/2019
Last updated
01/23/2024
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