Organization
SOUTHEAST MANAGEMENT SERVICES LLC
Active
Other names
Southeast Rehabilitation Associates PC
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ANDREW MAZUR M.D. (PRESIDENT)
(508) 679-1400
Entity
Organization
Contact information
Practice address
231 WEAVER ST, UNIT F, FALL RIVER, MA 02720-1338
(508) 679-1400
(508) 679-1449
Mailing address
231 WEAVER ST, UNIT F, FALL RIVER, MA 02720-1338
(508) 679-1400
(508) 679-1449
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
150693
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3152570
—
MA
01
—
766060
HARVARD PILGRIM
—
01
—
80503
HARVARD PILGRIM
—
Enumeration date
04/02/2014
Last updated
04/02/2014
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