| Organization Name: | CENTRAL MASSACHUSETTS AMBULATORY ENDOSCOPY CENTER LLC |
| NPI Number: | 1073682159 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | PHILLIP A. CLENDENIN (PRESIDENT) |
| Mailing Address: | 105 Erdman Way Leominster |
| State: | MA US |
| Postal Code: | 014531805 |
| Phone Number: | 9788406767 |
| Fax Number: | 9788406766 |
| NPI Enumeration Date: | 11/06/2006 |
| NPI Last Update Date: | 05/18/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QA1903X |
| License Number: | AQA3 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MA |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Ambulatory Surgical |
| Taxonomy Definition: | |