Organization
BOSTON IVF, INC.
Active
Parent organization
BOSTON IVF, INC.
Other names
The Surgery Center of Waltham
Organization subpart
Yes
Provider details
NPI number
Legal business name
BOSTON IVF, INC.
Authorized official
MR. DEREK M. LARKIN JD, MBA (DIRECTOR OF BUSINESS)
(781) 434-6500
Entity
Organization
Contact information
Practice address
130 2ND AVE, THE SURGERY CENTER OF WALTHAM, WALTHAM, MA 02451-1100
(781) 434-6400
(781) 434-6497
Mailing address
130 2ND AVE, THE SURGERY CENTER OF WALTHAM, WALTHAM, MA 02451-1100
(781) 434-6400
(781) 434-6497
Taxonomy
Speciality
Code
Description
License number
State
261QA0006X
Ambulatory Fertility Facility
4QLZ
MA
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
4QLZ
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1212524
—
MA
Enumeration date
10/31/2006
Last updated
08/24/2009
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