NPI 1063716579

Mgh

Organisation Exclusive Provider Organization Beverly, MA

Practice location

Address: 10 Tall Tree Dr, Beverly, MA 01915-2012
Phone: (978) 979-7410
Mailing address: 10 Tall Tree Drive, Beverly, MA 01915

Authorised official

Name: Lynne Brodsky
Title: MD
Phone: (617) 889-8580

Registered specialties (2)

Exclusive Provider Organization Primary

Managed Care Organizations Taxonomy 302F00000X Licence 179866 (MA)

Other Exclusive Provider Organization providers in Massachusetts →

Chronic Disease Hospital

Hospitals Taxonomy 281P00000X Licence 179866 (MA)

Other Chronic Disease Hospital providers in Massachusetts →

Registry record

NPI: 1063716579
Entity type: Organization
NPI issued: 28 Dec 2010
Record last updated: 28 Dec 2010

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.