Organization
CHARLTON ANESTHESIA GROUP, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
WILLIAM J PENHALLURICK MD (PRESIDENT)
(508) 279-3131
Entity
Organization
Contact information
Practice address
363 HIGHLAND AVE, FALL RIVER, MA 02720-3703
(508) 679-3131
(508) 679-7146
Mailing address
340 MAIN ST, STE. 670, WORCESTER, MA 01608-1604
(508) 764-3566
(508) 798-8012
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
—
MA
367500000X
Certified Registered Nurse Anesthetist
—
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
9704949
—
MA
Enumeration date
07/14/2005
Last updated
07/21/2022
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