Organization
COMMONWEALTH SURGICAL ASSOCIATES PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KELLY YANNALFO (PRACTICE MANAGER)
(781) 279-1123
Entity
Organization
Contact information
Practice address
91 MONTVALE AVE, SUITE 208, STONEHAM, MA 02180-3623
(781) 279-1123
(781) 438-3034
Mailing address
91 MONTVALE AVE, SUITE 208, STONEHAM, MA 02180-3623
(781) 279-1123
(781) 438-3034
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
9712194
—
MA
01
—
M17876
BCBS
MA
Enumeration date
03/14/2006
Last updated
01/25/2018
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