Organization
SEACOAST AFFILIATED GROUP PRACTICE, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARK GOLDSTEIN (PRESIDENT/CEO)
(978) 463-1010
Entity
Organization
Contact information
Practice address
25 HIGHLAND AVE, NEWBURYPORT, MA 01950-3867
(978) 463-1390
(978) 463-1190
Mailing address
25 HIGHLAND AVE, NEWBURYPORT, MA 01950-3867
(978) 463-1390
(978) 463-1190
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
9785906
—
MA
Enumeration date
06/21/2005
Last updated
10/09/2015
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