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Organization

KENNETH C PRUYN JR

Active
Other names
New England Mobility
Organization subpart
No

Provider details

NPI number
Authorized official
MR. KENNETH C PRUYN JR. (PRESIDENT)
(800) 652-6683
Entity
Organization

Contact information

Practice address
35 ARMSTRONG CT, BRIDGEWATER, MA 02324-2283
(800) 652-6683
(508) 697-5015
Mailing address
35 ARMSTRONG CT, BRIDGEWATER, MA 02324-2283
(800) 652-6683
(508) 697-5015

Taxonomy

Speciality
Code
Description
License number
State
332BC3200X
Customized Equipment (DME)
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1538136
MA
01
316454
BLUE CROSS PROVIDER
MA
Enumeration date
12/21/2005
Last updated
11/06/2007
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