Organization
NEW ENGLAND REPRODUCTIVE MEDICINE AND SURGERY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRIAN CLARK M.D. (PRESIDENT)
(508) 917-3720
Entity
Organization
Contact information
Practice address
22 WEST ST, SUITE 25, MILLBURY, MA 01527-2622
(508) 238-8646
Mailing address
22 WEST ST STE 25, MILLBURY, MA 01527-2677
(508) 917-6720
(508) 917-6721
Taxonomy
Speciality
Code
Description
License number
State
207VE0102X
Reproductive Endocrinology Physician
Primary
226853
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
110099291A
—
MA
Enumeration date
11/01/2013
Last updated
03/01/2021
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