Organization
ANESTHETICS OF BROCKTON, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. FATHALLA M MASHALI MD (PRESIDENT)
(401) 490-2130
Entity
Organization
Contact information
Practice address
680 CENTRE ST, ANESTHETICS OF BROCKTON, PC, BROCKTON, MA 02302-3308
(508) 941-7000
Mailing address
42 HEMINGWAY DR, RIVERSIDE, RI 02915-2224
(401) 490-2130
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
—
—
367500000X
Certified Registered Nurse Anesthetist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
9750720
—
MA
Enumeration date
07/04/2006
Last updated
09/11/2025
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