NPIMap

Organization Active NPI

North Shore Diagnostics, Inc.

  • Physiological Laboratory
  • Woburn, MA
National Provider Identifier
1902931629
Registry record updated Feb 23, 2012
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Key facts

NPPES NPI Registry
Primary specialty
Physiological LaboratoryTaxonomy code 293D00000X
Legal business name
NORTH SHORE DIAGNOSTICS, INC.
Practice address
2 Rehabilitation Way
Woburn, MA 01801-6003
Phone
(781) 729-7383
NPI assigned
Feb 22, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 23, 2012

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

Authorized official

Name
Dr. Ronald L. Nath, MD
Title
Executive Director
Phone
(781) 729-7383

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physiological Laboratory 293D00000X Primary

Addresses

Primary practice location

2 Rehabilitation Way
Woburn, MA 01801-6003

Mailing address

PO Box 2645
Woburn, MA 01888-1245
Phone (781) 729-7383

Other identifiers 1

IdentifierTypeStateIssuer
036969OtherMABLUE CROSS BLUE SHIELD

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1172102400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1329955200000",
    "number": "1902931629",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2645",
            "city": "WOBURN",
            "state": "MA",
            "postal_code": "018881245",
            "telephone_number": "781-729-7383"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 REHABILITATION WAY",
            "city": "WOBURN",
            "state": "MA",
            "postal_code": "018016003",
            "telephone_number": "781-729-7383"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTH SHORE DIAGNOSTICS, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-22",
        "last_updated": "2012-02-23",
        "status": "A",
        "authorized_official_last_name": "NATH",
        "authorized_official_first_name": "RONALD",
        "authorized_official_middle_name": "L.",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "781-729-7383",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "293D00000X",
            "taxonomy_group": "",
            "desc": "Physiological Laboratory",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "036969",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Woburn, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 2012; 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.