COMMONWEALTH OB-GYN PC NPI 1912082694

NPI Details

COMMONWEALTH OB-GYN, PC is a specialist in Brookline, MA. The provider is an individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. COMMONWEALTH OB-GYN, PC NPI is 1912082694. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

1 BROOKLINE PL
SUITE 305
BROOKLINE, MA
ZIP 02445-224
Phone: (617) 732-1510
Fax: (617) 732-0986

The provider's authorized official is Derna Demaggio .
The authorized official title is President and has the following contact phone number (617) 732-1510.

The CLIA number assigned to this NPI record is 22D1030927 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 10/25/2006 and was last updated on 10/1/2007.

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: