Provider Type Icon

NORTHEAST MEDICAL PRACTICE NPI 1366642662


NPI Information

NPI: 1366642662
Provider Name: NORTHEAST MEDICAL PRACTICE

Doing Business As: NORTHEAST ONCOLOGY

Classification: Internal Medicine - 207RH0003X
Entity Type: Organization

Specialization: Hematology & Oncology

Address:
85 HERRICK ST
BEVERLY, MA
ZIP 01915
Phone: (978) 927-6850
Get Directions

NORTHEAST MEDICAL PRACTICE is a hematology and oncology internal medicine in Beverly, MA. The provider is an internist doctor of osteopathy that specializes in the treatment of the combination of hematology and oncology disorders. A doctor of osteopathy that is board eligible/certified by the American Osteopathic Board of Internal Medicine WAS able to obtain a Certificate of Special Qualifications in the field of Hematology and Oncology. The Certificate is NO longer offered. NORTHEAST MEDICAL PRACTICE NPI is 1366642662. The provider is registered as an organization entity type and is a single specialty group.
The provider Is Doing Business As Northeast Oncology.

The provider's business location address is:

85 HERRICK ST
BEVERLY, MA
ZIP 01915-790
Phone: (978) 927-6850

The provider's authorized official is Phyllis Fabello .
The authorized official title is Compliance Officer and has the following contact phone number (978) 236-1710.

The enumeration date for this NPI number is 7/24/2007 and was last updated on 7/24/2007.


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
1207RH0003XInternal MedicineHematology & Oncology49044MASSACHUSETTSYes

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
19779485MEDICAIDMASSACHUSETTS

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

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.