Organization
FOREST PARK MRI ASSOCIATES, PC
Active
Other names
The MRI Center of Woburn
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ROBERT A SANTAMARIA (CHIEF FINANCIAL OFFICER)
(781) 569-6541
Entity
Organization
Contact information
Practice address
800 W CUMMINGS PARK, SUITE 1150, WOBURN, MA 01801-6372
(781) 932-8650
(781) 932-8619
Mailing address
800 W CUMMINGS PARK, SUITE 1350, WOBURN, MA 01801-6372
(781) 569-6541
(781) 569-6557
Taxonomy
Speciality
Code
Description
License number
State
261QM1200X
Magnetic Resonance Imaging (MRI) Clinic/Center
Primary
—
—
261QR0200X
Radiology Clinic/Center
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0004301
MEDICARE IDTF PTAN
MA
05
—
110029170A
—
MA
Enumeration date
05/17/2006
Last updated
05/11/2011
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