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DEDHAM MEDICAL ASSOCIATE NPI 1063430643


NPI Information

NPI: 1063430643
Provider Name: DEDHAM MEDICAL ASSOCIATE
Classification: Radiology - 2085R0202X
Entity Type: Organization

Specialization: Diagnostic Radiology

Address:
1 LYONS STREET
DEDHAM, MA
ZIP 02026
Phone: (781) 329-1400
Get Directions

DEDHAM MEDICAL ASSOCIATE is a diagnostic radiology radiology in Dedham, MA. The provider is a radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. DEDHAM MEDICAL ASSOCIATE NPI is 1063430643. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

1 LYONS STREET
DEDHAM, MA
ZIP 02026
Phone: (781) 329-1400
Fax: (781) 278-5667

The provider's authorized official is Richard M Russo .
The authorized official title is Cfo and has the following contact phone number (781) 278-5540.

The enumeration date for this NPI number is 7/18/2006 and was last updated on 7/21/2022.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
12085R0202XRadiologyDiagnostic RadiologyMASSACHUSETTSYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
19766618MEDICAIDMASSACHUSETTS
29766553MEDICAIDMASSACHUSETTS
39766537MEDICAIDMASSACHUSETTS
49766545MEDICAIDMASSACHUSETTS
59766588MEDICAIDMASSACHUSETTS
69766529MEDICAIDMASSACHUSETTS
79766561MEDICAIDMASSACHUSETTS
8M12735MEDICAIDMASSACHUSETTS
99766626MEDICAIDMASSACHUSETTS
109766634MEDICAIDMASSACHUSETTS
11M11531MEDICAIDMASSACHUSETTS
129766596MEDICAIDMASSACHUSETTS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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