| Organization Name: | NORTHEAST AMBULATORY CENTER |
| NPI Number: | 1205024569 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | ANIL KUMAR (MEDICAL DIRECTOR) |
| Mailing Address: | 3 Woodland Rd Suite 321 Stoneham |
| State: | MA US |
| Postal Code: | 021801702 |
| Phone Number: | 7816655233 |
| Fax Number: | 7816621497 |
| NPI Enumeration Date: | 10/11/2007 |
| NPI Last Update Date: | 10/11/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QA1903X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MA |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Ambulatory Surgical |
| Taxonomy Definition: | |