NPIMap

Organization Active NPI

Merrimack Valley Child & Adolescent Health

  • Pediatrics Physician
  • Haverhill, MA
National Provider Identifier
1104910777
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
79899 Issued in MA
Legal business name
MERRIMACK VALLEY CHILD & ADOLESCENT HEALTH
Practice address
62 Brown St
Suite 503
Haverhill, MA 01830
Phone
(978) 521-8108
Fax
(978) 521-8372
NPI assigned
Oct 3, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Carolyn Roy-Bornstein, MDNPI 1982690533
Title
Partner
Phone
(978) 521-8108

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 79899 MA Primary

Addresses

Primary practice location

62 Brown St
Suite 503
Haverhill, MA 01830

Mailing address

62 Brown St
Suite 503
Haverhill, MA 01830
Phone (978) 521-8108

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1159833600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1104910777",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "62 BROWN ST",
            "address_2": "SUITE 503",
            "city": "HAVERHILL",
            "state": "MA",
            "postal_code": "01830",
            "telephone_number": "978-521-8108",
            "fax_number": "978-521-8372"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "62 BROWN ST",
            "address_2": "SUITE 503",
            "city": "HAVERHILL",
            "state": "MA",
            "postal_code": "01830",
            "telephone_number": "978-521-8108",
            "fax_number": "978-521-8372"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MERRIMACK VALLEY CHILD & ADOLESCENT HEALTH",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-03",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "ROY-BORNSTEIN",
        "authorized_official_first_name": "CAROLYN",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "978-521-8108",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MA",
            "license": "79899",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Haverhill, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.