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Organization

CAVERNOSA CORPORATION

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. ABRAHAM MORGENTALER MD, FACS (FOUNDER/PRESIDENT)
(617) 277-5000
Entity
Organization

Contact information

Practice address
ONE BROOKLINE PLACE, STE 624, BROOKLINE, MA 02445
(617) 277-5000
(617) 277-5444
Mailing address
ONE BROOKLINE PLACE, STE 624, BROOKLINE, MA 02445
(617) 277-5000
(617) 277-5444

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
54417
MA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
9702261
MA
Enumeration date
11/02/2006
Last updated
08/22/2020
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