Mystic Valley Pediatrics
LBN: Winchester Physician Associates
Mystic Valley Pediatrics is an health care organization with primary practice located at 75 Riverside Ave 2, Medford MA 02155-4600. The organization recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as the primary health care specialty.
Winchester Physician Associates can be contacted via phone (781) 391-8821, or through Wills, Eileen via phone (781) 756-7273.
Contact Information
Primary practice address
75 Riverside Ave 2
Medford MA 02155-4600
Phone: (781) 391-8821
Fax: (781) 395-8798
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Pediatrics | 208000000X | 73788 | Massachusetts |
| Allopathic & Osteopathic Physicians / Pediatrics | 208000000X | 73721 | Massachusetts |
| Allopathic & Osteopathic Physicians / Pediatrics | 208000000X | 74993 | Massachusetts |
Profile Details
| NPI number | 1043293731 |
|---|---|
| LBN Legal business name | Winchester Physician Associates |
| DBA Doing business as | Mystic Valley Pediatrics |
| Authorized official | Wills, Eileen |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Nov 28th, 2005 |
| Last updated | Mar 20th, 2008 - about 16 years ago |
1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1043293731 | NPPES |
| Massachusetts | MEDICAID | 9777229 |
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