Organization
HALLMARK HEALTH MEDICAL ASSOCIATES INC
Active
Parent organization
HALLMARK HEALTH CORPORATION
Other names
HHMA-NECQA
Organization subpart
Yes
Provider details
NPI number
Legal business name
HALLMARK HEALTH CORPORATION
Authorized official
MR. MICHAEL S TURILLI (VP FISCAL SERVICES)
(781) 338-7415
Entity
Organization
Contact information
Practice address
170 GOVERNORS AVE, ATTN: PROVIDER ENROLLMENT-HHMA (3) CONTACT, MEDFORD, MA 02155-1643
(781) 338-7521
(781) 338-7531
Mailing address
PO BOX 3237, HALLMARK HEALTH MEDICAL ASSOCIATES INC (3), WOBURN, MA 01888-3237
(781) 338-7170
(781) 338-7173
Taxonomy
Speciality
Code
Description
License number
State
207VX0000X
Obstetrics Physician
Primary
—
—
208600000X
Surgery Physician
—
—
2086S0129X
Vascular Surgery Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
NECQA / IPA BE#
WINCH-IPA-BCBS
MA
Enumeration date
04/29/2010
Last updated
01/13/2012
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