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MYSTIC VALLEY UROLOGICAL ASSOCIATES INC NPI 1114452547


NPI Information

NPI: 1114452547
Provider Name: MYSTIC VALLEY UROLOGICAL ASSOCIATES, INC

Other Name: MYSTIC VALLEY UROLOGICAL ASSOCIATES, TOO

Classification: Urology - 208800000X
Entity Type: Organization
Address:
3 WOODLAND RD
SUITE 216
STONEHAM, MA
ZIP 02180
Phone: (781) 979-0661
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MYSTIC VALLEY UROLOGICAL ASSOCIATES, INC is an urology in Stoneham, MA. The provider is a urologist manages benign and malignant medical and surgical disorders of the genitourinary system and the adrenal gland. This specialist has comprehensive knowledge of and skills in endoscopic, percutaneous and open surgery of congenital and acquired conditions of the urinary and reproductive systems and their contiguous structures. MYSTIC VALLEY UROLOGICAL ASSOCIATES, INC NPI is 1114452547. The provider is registered as an organization entity type and is a single specialty group.
The provider Other Name Is Mystic Valley Urological Associates, Too.

The provider's business location address is:

3 WOODLAND RD
SUITE 216
STONEHAM, MA
ZIP 02180-702
Phone: (781) 979-0661
Fax: (781) 979-0372

The provider's authorized official is Marjie C Haluska .
The authorized official title is Director Of Business Operations and has the following contact phone number (781) 462-3040.

The enumeration date for this NPI number is 4/24/2017 and was last updated on 4/24/2017.


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
1208800000XUrologyYes

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
1M13568MEDICARE UPINMASSACHUSETTS

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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