Organization
ORTHOPEDIC SURGERY OF QUINCY INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHARLES A DICECCA M.D. (M.D./SOLE OWNER)
(617) 773-7457
Entity
Organization
Contact information
Practice address
300 CONGRESS STREET, SUITE 308, QUINCY, MA 02169
(617) 773-7457
(617) 773-0299
Mailing address
300 CONGRESS STREET, SUITE 308, QUINCY, MA 02169
(617) 773-7457
(617) 773-0299
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
705664
TUFTS
MA
05
—
9707808
—
MA
01
—
M11024
MA BCBS
MA
Enumeration date
08/20/2006
Last updated
02/01/2017
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