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Organization

COASTAL MEDICAL ASSOCIATES, INC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
JACLYN VALANZOLA (PROVIDER ENROLLMENT)
(781) 681-0384
Entity
Organization

Contact information

Practice address
55 FOGG RD, WEYMOUTH, MA 02190-2432
(781) 624-8000
Mailing address
141 LONGWATER DR, NORWELL, MA 02061-1632
(781) 681-0384

Taxonomy

Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
207LC0200X
Critical Care Medicine (Anesthesiology) Physician
207LH0002X
Hospice and Palliative Medicine (Anesthesiology) Physician
207LP2900X
Pain Medicine (Anesthesiology) Physician

Other

Enumeration date
04/20/2021
Last updated
01/23/2024
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