Organization
NORTHEAST UROLOGIC SURGERY, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
STEVEN R PREVITE MD (PRESIDENT)
(978) 686-3877
Entity
Organization
Contact information
Practice address
231 SUTTON ST, STE 1D, NORTH ANDOVER, MA 01845-1620
(978) 686-3877
(978) 686-9586
Mailing address
231 SUTTON ST, STE 1D, NORTH ANDOVER, MA 01845-1620
(978) 686-3877
(978) 686-9586
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
9719911
—
MA
05
—
99904764
—
NH
01
—
M12943
BLUE CROSS BLUE SHIELD MA
MA
Enumeration date
07/14/2011
Last updated
07/14/2011
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