Organization
MASSACHUSETTS GENERAL PHYSICIANS ORGANIZATION, INC
Active
Other names
MGPO Orthopaedic Sports Medicine and Upper Extremity Center
Organization subpart
No
Provider details
NPI number
Authorized official
JOANNA HAZELL (DIRECTOR, PROVIDER ENROLLMENT)
(781) 254-4854
Entity
Organization
Contact information
Practice address
52 SECOND AVE STE 3300, WALTHAM, MA 02451-1155
(781) 487-6064
Mailing address
PO BOX 419095, BOSTON, MA 02241-9095
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
110000037C
—
MA
Enumeration date
08/17/2022
Last updated
05/04/2026
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