Secon of New England LLC

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

Legal business name

SECON OF NEW ENGLAND LLC

Practice address

415 Main St
Ste 4
Worcester, MA 01608-1706

Phone

(508) 831-0703

Fax

(508) 831-0803

NPI assigned

Jun 15, 2005

Organization subpart

No

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

Authorized official

Name

Ms. Sylvia Lynn Freeman

Title

MGR of Credentialing/Enrollment

Phone

(508) 304-7602

Specialties & licenses 2

Addresses

Other identifiers 9

Locations

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

{
    "created_epoch": "1118793600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1678060800000",
    "number": "1487659694",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 830525",
            "address_2": "#OWC 30",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352830525",
            "telephone_number": "508-304-7602",
            "fax_number": "508-304-7602"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "415 MAIN ST",
            "address_2": "STE 4",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016081706",
            "telephone_number": "508-831-0703",
            "fax_number": "508-831-0803"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SECON OF NEW ENGLAND LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-06-15",
        "last_updated": "2023-03-06",
        "certification_date": "2023-03-06",
        "status": "A",
        "authorized_official_last_name": "FREEMAN",
        "authorized_official_first_name": "SYLVIA",
        "authorized_official_middle_name": "LYNN",
        "authorized_official_title_or_position": "MGR OF CREDENTIALING/ENROLLMENT",
        "authorized_official_telephone_number": "508-304-7602",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "MA",
            "license": "2465",
            "primary": false
        },
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA PIN",
            "identifier": "0007640552",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200024710A",
            "state": "OK"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FALLON PIN",
            "identifier": "41933",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "TR0084",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4401024",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TUFTS HEALTH",
            "identifier": "691566",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0816931",
            "state": "MA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000000027970",
            "state": "MA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30803284",
            "state": "NH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Carly Elizabeth Sebastian, LICSW
• Victoria Sebastian
• Abderrahman Sebbai
• Steffi Thomas Sebin
• Moussa Seck
• R. Mimi Clarke Secor, NP
• Secure Transitions & Transport Corp
• Morgan Sedgley
• Paul Sedgwick, MD
• Abigail Lamb Seeley, OTR/L

• Clinical Medical Laboratory in Worcester, MA
• Providers in Worcester, MA by specialty
• Clinical Medical Laboratory in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 2023; 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.