PREMISE HEALTH OF MASSACHUSETTS MEDICAL PC NPI 1215231071

NPI Information

NPI: 1215231071
Provider Name: PREMISE HEALTH OF MASSACHUSETTS, MEDICAL PC

Doing Business As: FIDELITY HEALTH & WELLNESS CENTER

Classification: Clinic/Center - 261QU0200X
Entity Type: Organization

Specialization: Urgent Care

Address:
245 SUMMER ST STE 1100
BOSTON, MA
ZIP 02210
Phone: (617) 563-9119
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PREMISE HEALTH OF MASSACHUSETTS, MEDICAL PC is an urgent care clinic center in Boston, MA. PREMISE HEALTH OF MASSACHUSETTS, MEDICAL PC NPI is 1215231071. The provider is registered as an organization entity type.
The provider Is Doing Business As Fidelity Health & Wellness Center.

The provider's business location address is:

245 SUMMER ST STE 1100
BOSTON, MA
ZIP 02210
Phone: (617) 563-9119
Fax: (617) 692-6389

The provider's authorized official is Jon Leizman .
The authorized official title is President and has the following contact phone number (216) 479-9063.

The CLIA number assigned to this NPI record is 22D1070925 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 1/7/2011 and was last updated on 8/24/2022.

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 Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QP2300X	Clinic/Center	Primary Care			No
2	261QU0200X	Clinic/Center	Urgent Care			Yes

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

NPI Synchronization or Removal

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