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MYSTIC VALLEY UROLOGICAL ASSOC INC NPI 1689903882


NPI Information

NPI: 1689903882
Provider Name: MYSTIC VALLEY UROLOGICAL ASSOC INC
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 ASSOC 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 ASSOC INC NPI is 1689903882. The provider is registered as an organization entity type and is a single specialty group.

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 Haluska .
The authorized official title is Director Of Business Operations and has the following contact phone number (781) 979-0661.

The enumeration date for this NPI number is 12/17/2009 and was last updated on 1/13/2011.


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
1208800000XUrologyMASSACHUSETTSYes

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
1CL0638OTHERMASSACHUSETTSRRMED
29723757MEDICAIDMASSACHUSETTS
328749OTHERMASSACHUSETTSFALLON
49723757OTHERMASSACHUSETTSNETWORK HEALTH
5M13568OTHERMASSACHUSETTSBCBSMA
6600296OTHERMASSACHUSETTSTUFTS
70009638OTHERMASSACHUSETTSNHP
8M13568OTHERMASSACHUSETTSMEDICARE ID-TYPE UNSPECIFIED

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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