OPTIMAL PROFESSIONAL HEALTH SERVICES PC NPI 1881059665

NPI Information

NPI: 1881059665
Provider Name: OPTIMAL PROFESSIONAL HEALTH SERVICES PC
Classification: General Practice - 208D00000X
Entity Type: Organization
Address:
1418 PROVIDENCE HWY
SUITE N
NORWOOD, MA
ZIP 02062
Phone: (617) 964-1440
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OPTIMAL PROFESSIONAL HEALTH SERVICES PC is a general practice in Norwood, MA. The provider is a physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions. Source: National Uniform Claim Committee OPTIMAL PROFESSIONAL HEALTH SERVICES PC NPI is 1881059665. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

1418 PROVIDENCE HWY
SUITE N
NORWOOD, MA
ZIP 02062-655
Phone: (617) 964-1440
Fax: (617) 964-7833

The provider's authorized official is Joseph A Russo .
The authorized official title is Owner and has the following contact phone number (617) 364-1440.

The enumeration date for this NPI number is 12/22/2015 and was last updated on 5/11/2016.

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	208D00000X	General Practice				Yes

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 Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	110109264A	MEDICAID	MASSACHUSETTS
2	S100283834	MEDICARE PIN	MASSACHUSETTS

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: 5/5/2024

NPI Synchronization or Removal

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