Basic Information
| Provider Information | |||||||||
| NPI: | 1427599588 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | WINCHESTER ANESTHESIA ASSOCIATES 2 INC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1342 BELMONT ST STE 205 | ||||||||
| Address2: | |||||||||
| City: | BROCKTON | ||||||||
| State: | MA | ||||||||
| PostalCode: | 023014438 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5085801670 | ||||||||
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| Practice Location | |||||||||
| Address1: | 41 HIGHLAND AVE | ||||||||
| Address2: | |||||||||
| City: | WINCHESTER | ||||||||
| State: | MA | ||||||||
| PostalCode: | 018901446 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7817567243 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 03/09/2017 | ||||||||
| LastUpdateDate: | 06/01/2021 | ||||||||
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| AuthorizedOfficialLastName: | RIELEY | ||||||||
| AuthorizedOfficialFirstName: | LEWIS | ||||||||
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| AuthorizedOfficialTitleorPosition: | TREASURER | ||||||||
| AuthorizedOfficialTelephone: | 7817562190 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
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| AuthorizedOfficialCredential: | MD | ||||||||
| NPICertificationDate: | 05/14/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207LP2900X | N | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Anesthesiology | Pain Medicine | 207L00000X | Y | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Anesthesiology |
No ID Information.