Organization
BAY MEDICAL SYSTEMS ASSOCIATES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOSEPH CHELALES (ADMINISTRATOR)
(646) 285-4035
Entity
Organization
Contact information
Practice address
29 MAIN ST STE 101, MILLBURY, MA 01527-2005
(508) 388-5563
(508) 635-9658
Mailing address
PO BOX 1687, LAKE WORTH, FL 33460-1687
Taxonomy
Speciality
Code
Description
License number
State
207RA0401X
Addiction Medicine (Internal Medicine) Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
XX-XXX5436
TIN
MA
Enumeration date
09/11/2018
Last updated
09/11/2018
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