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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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