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DEDHAM MEDICAL ASSOC INC NPI 1740280817


NPI Information

NPI: 1740280817
Provider Name: DEDHAM MEDICAL ASSOC INC
Classification: Pediatrics - 208000000X
Entity Type: Organization
Address:
1 LYONS ST
DEDHAM, MA
ZIP 02026
Phone: (781) 329-1400
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DEDHAM MEDICAL ASSOC INC is a pediatrics in Dedham, MA. The provider is a pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. DEDHAM MEDICAL ASSOC INC NPI is 1740280817. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

1 LYONS ST
DEDHAM, MA
ZIP 02026-599
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 7/29/2005 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
1208000000XPediatricsMASSACHUSETTSYes

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
19766537MEDICAIDMASSACHUSETTS
29766545MEDICAIDMASSACHUSETTS
39766553MEDICAIDMASSACHUSETTS
49766618MEDICAIDMASSACHUSETTS
59766634MEDICAIDMASSACHUSETTS
69766529MEDICAIDMASSACHUSETTS
79766561MEDICAIDMASSACHUSETTS
89766588MEDICAIDMASSACHUSETTS
99766626MEDICAIDMASSACHUSETTS
109766596MEDICAIDMASSACHUSETTS

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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