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Organization

TWINBROOK SURGICAL ASSOCIATES

Active
Organization subpart
No

Provider details

NPI number
Authorized official
THOMAS JOSEPH GRADY M D (PRESIDENT)
(781) 893-6520
Entity
Organization

Contact information

Practice address
20 HOPE AVE, STE 207, WALTHAM, MA 02453-2721
(781) 893-6520
(781) 893-6522
Mailing address
20 HOPE AVE, STE 207, WALTHAM, MA 02453-2721
(781) 893-6520
(781) 893-6522

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
2086S0129X
Vascular Surgery Physician
208C00000X
Colon & Rectal Surgery Physician

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
9701346
MA
01
CJ0290
RAILROAD MEDICARE
MA
Enumeration date
11/18/2005
Last updated
07/30/2008
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