Organization
NORTHEAST AMBULATORY CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANIL KUMAR MD (MEDICAL DIRECTOR)
(781) 665-5233
Entity
Organization
Contact information
Practice address
3 WOODLAND RD, SUITE 321, STONEHAM, MA 02180-1702
(781) 665-5233
(781) 662-1497
Mailing address
3 WOODLAND RD, SUITE 321, STONEHAM, MA 02180-1702
(781) 665-5233
(781) 662-1497
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
—
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
038569
MA BLUE CROSS
MA
Enumeration date
10/11/2007
Last updated
10/11/2007
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