| Organization Name: | COMMONWEALTH ENDOSCOPY CENTER, INC |
| NPI Number: | 1154415305 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | JERRY S STERN (MEDICAL DIRECTOR) |
| Mailing Address: | 120 W Center St West Bridgewater |
| State: | MA US |
| Postal Code: | 023791600 |
| Phone Number: | 5085868700 |
| Fax Number: | 5085868638 |
| NPI Enumeration Date: | 10/03/2006 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QE0800X |
| License Number: | EXEMPT |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MA |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Endoscopy |
| Taxonomy Definition: | |