Organization
NORTHEAST PHYSICIAN PRACTICE
Active
Other names
OB/GYN Associates
Organization subpart
No
Provider details
NPI number
Authorized official
KIM ROUILLARD (CREDENTIALING MANAGER)
(978) 818-6110
Entity
Organization
Contact information
Practice address
225 BOSTON ST, SUITE 205, LYNN, MA 01904-3137
(781) 595-4544
(781) 581-3740
Mailing address
PO BOX 2149, NEMSO, DANVERS, MA 01923-5149
(978) 818-6110
(978) 818-6115
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Enumeration date
06/29/2006
Last updated
08/22/2020
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