Organization

Northeast Medical Group, Inc.

Legal Business Name

Northeast Medical Group, Inc.

NPI Number

1043278351

NPI Type

Organization

Enumeration Date

05/03/2006

Specialties

(Taxonomies)

Contact
Information

Purpose

Mailing
Location

Address

PO BOX 415126
226 MILL HILL AVENUE

City

Boston
Bridgeport

State

MA
CT

Postal Code

02241-0001
06610

Country

US
US

Telephone Number

(203) 384-3975
(203) 384-3975

Authorized Official

Name

Beata Bialczak

Title or Position

MANAGER

Telephone Number

(203) 384-3975

Identifiers

Identifier

004112257
008008038
004118388
004223517
004118396
008001858
004212958
004229317
008002043
Unknown
Unknown
Unknown

Identifier State

CT
CT
CT
CT
CT
CT
CT
CT
CT
Unknown
Unknown
Unknown

Identifier Issuer

Unknown
Unknown
Unknown
Unknown
Unknown
Unknown
Unknown
Unknown
Unknown
Unknown
Unknown
Unknown

Provider data last refreshed from NPPES NPI registry on 11/19/2024

Data last updated by provider on 12/22/2021

Provider Address