Organization
RANDOLPH D. MALONEY, M.D., PC
Active
Other names
North Shore Vascular Diagnostic Laboratory
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RANDOLPH DAVID MALONEY M.D. (MEDICAL DIRECTOR PRESIDENT)
(978) 922-5535
Entity
Organization
Contact information
Practice address
75 HERRICK ST, SUITE 110 - PARKHURST MEDICAL BLDG., BEVERLY, MA 01915-5900
(978) 922-5535
(978) 922-5667
Mailing address
75 HERRICK ST, SUITE 110 - PARKHURST MEDICAL BLDG., BEVERLY, MA 01915-5900
(978) 922-5535
(978) 922-5667
Taxonomy
Speciality
Code
Description
License number
State
2471V0105X
Vascular Sonography Radiologic Technologist
RDMS-RVT
MA
293D00000X
Physiological Laboratory
Primary
35297
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
021569
BLUECROSS/BLUESHIELD
MA
01
—
33434
FALLON HEALTH
MA
01
—
606913
HARVARD PILGRAM
MA
01
—
801461
TUFTS
MA
01
—
950000914
RAILROAD MEDICARE
MA
05
—
9769706
—
MA
Enumeration date
08/05/2006
Last updated
06/21/2018
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