| Organization Name: | SPORTS MEDICINE NORTH ORTHOPAEDIC SURGERY,INC |
| NPI Number: | 1033481494 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | JEFFREY POLANSKY (PRESIDENT) |
| Mailing Address: | 1 Orthopedics Dr 2nd Floor Peabody |
| State: | MA US |
| Postal Code: | 019601668 |
| Phone Number: | 9788186350 |
| Fax Number: | 9788186355 |
| NPI Enumeration Date: | 02/01/2012 |
| NPI Last Update Date: | 02/01/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 213ES0103X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Podiatric Medicine & Surgery Service Providers |
| Taxonomy Classification: | Podiatrist |
| Taxonomy Specialization: | Foot & Ankle Surgery |
| Taxonomy Definition: | |