Organization Name: | BREAST CENTER OF SOUTH COAST, LLC |
NPI Number: | 1629177597 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | PATRICIA ANDRADE (PRESIDENT) |
Mailing Address: | 52 Brigham St Suite 3 New Bedford |
State: | MA US |
Postal Code: | 027402210 |
Phone Number: | 5089902220 |
Fax Number: | 5089949628 |
NPI Enumeration Date: | 09/21/2006 |
NPI Last Update Date: | 10/11/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MA |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |